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CYTOLOGY LABORATORY REQUISITION PATIENT IS NAME (LAST) PATIENT NAME ADDRESS CITY STATE ORDERING MD / SUBMITTING PHYSICIAN BILL TO: PATIENT/INSURANCE ALTERNATE PATIENT IS ADDRESS SEND ADDITIONAL COPY

How to fill out cytology laboratory requisition phone

How to fill out a cytology laboratory requisition form:

1. Start by carefully reading the instructions on the form to ensure you understand what information is required.
2. Begin by filling out your personal information, such as your name, contact details, and any identification numbers or codes provided.
3. Next, provide the necessary patient information, including their full name, date of birth, and any other applicable identification details like their medical record number.
4. Specify the date and time the sample was collected or obtained.
5. Indicate the type of sample being submitted for analysis, whether it is a tissue biopsy, body fluid, or other specimen.
6. Provide any relevant clinical history or information that may aid in the interpretation of the test results.
7. Clearly state the test(s) requested and any additional special instructions or preferences.
8. If applicable, list any specific areas of concern or additional tests you would like to be performed on the specimen.
9. Ensure that the form is signed and dated by the requesting healthcare professional.
10. Finally, review the completed requisition form for any errors or missing information before submitting it to the cytology laboratory.

Who needs a cytology laboratory requisition form?

1. Healthcare professionals such as physicians, surgeons, pathologists, or other medical specialists who wish to request cytology testing for their patients may require a cytology laboratory requisition form.
2. Hospitals, clinics, and medical laboratories that offer or outsource cytology services may require healthcare professionals to fill out a requisition form to ensure accurate specimen processing and analysis.
3. Patients who have been advised by their healthcare provider to undergo cytology testing may also be given a requisition form to bring along to the laboratory for sample collection.

For pdfFiller’s FAQs

What is cytology laboratory requisition phone?

The cytology laboratory requisition phone is the contact information provided on the form for requesting cytology testing.

Who is required to file cytology laboratory requisition phone?

Healthcare providers or medical staff responsible for ordering cytology testing are required to file the cytology laboratory requisition phone.

How to fill out cytology laboratory requisition phone?

The cytology laboratory requisition phone should be filled out by providing the correct contact information for the healthcare provider or medical staff ordering the cytology testing.

What is the purpose of cytology laboratory requisition phone?

The purpose of the cytology laboratory requisition phone is to ensure that the healthcare provider or medical staff ordering the cytology testing can be easily contacted for any necessary follow-up or clarification.

What information must be reported on cytology laboratory requisition phone?

The cytology laboratory requisition phone should include the name, contact number, and possibly the email address of the healthcare provider or medical staff ordering the cytology testing.

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