Get the free Oncology Cytogenetics Referral Form. Form to be used for referral of oncology samples

LF-G-163 Version 5. 0 Cancer Genetics CANCER GENETICS REFERRAL FORM - LIQUID SAMPLES Patient Details Referring Hospital Surname Forename Hospital Consultant DOB Sex M / F e-mail address Hospital Number NHS Number Signed Clinical details/reason for referral Sample type BM PB Other specify Urgent Routine If urgent please state why and give date if applicable Date sample taken Time sample taken Test requested - cytogenetics Karyotype PML-RARA Please send 20ml of PB and 1-5ml of BM in EDTA FISH...

How to fill out oncology cytogenetics referral form

How to fill out oncology cytogenetics referral form

1. Start by obtaining the oncology cytogenetics referral form from the lab or clinic where the testing will be done.
2. Fill out the patient's personal information such as name, date of birth, and contact details in the designated sections of the form.
3. Provide relevant medical history and any additional information that may be useful for the cytogenetics testing in the appropriate sections.
4. Indicate the reason for the referral and specify the type of cytogenetics test required, if known.
5. Include details of the treating physician or healthcare provider who is requesting the cytogenetics testing.
6. Ensure all necessary signatures are obtained, including the patient's consent for the test, if required.
7. Submit the completed referral form to the laboratory or clinic, following their specific instructions or procedures.
8. Retain a copy of the referral form for your records, if necessary.

Who needs oncology cytogenetics referral form?

1. Individuals suspected or diagnosed with cancer may require an oncology cytogenetics referral form.
2. Healthcare professionals, such as oncologists, hematologists, or genetic counselors, who are managing patients with suspected or confirmed cancer may also need to fill out the form.
3. Referrals for oncology cytogenetics testing may be necessary to aid in diagnosis, determine prognosis, guide treatment decisions, or monitor treatment response.
4. The specific criteria for who needs the referral form may vary depending on the policies and guidelines of the healthcare institution or laboratory.

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What is oncology cytogenetics referral form?

The oncology cytogenetics referral form is a document used to refer a patient to a specialist for genetic testing and analysis related to cancer.

Who is required to file oncology cytogenetics referral form?

Healthcare providers, oncologists, or specialists involved in the treatment of cancer patients are required to file the oncology cytogenetics referral form.

How to fill out oncology cytogenetics referral form?

The oncology cytogenetics referral form should be filled out with the patient's information, medical history, reason for referral, and relevant test results.

What is the purpose of oncology cytogenetics referral form?

The purpose of the oncology cytogenetics referral form is to facilitate genetic testing and analysis to assist in the diagnosis and treatment of cancer.

What information must be reported on oncology cytogenetics referral form?

The oncology cytogenetics referral form must include the patient's name, contact information, medical history, reason for referral, and any relevant test results.