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Tumor Cytogenomics Laboratory Requisition Form Mount Sinai Clinical Labs 1428 Madison Avenue (Tran Building) TEL: PLACE STICKER HERE Laboratory Accession Number: 212-241-8801 2nd floor, Room 250 Fax:

How to fill out tumor cytogenomics laboratory requisition

How to Fill Out Tumor Cytogenomics Laboratory Requisition:

Start by carefully reading the instructions:

The first step is to thoroughly review the instructions provided with the tumor cytogenomics laboratory requisition form. This will help you understand the required information and any specific guidelines or recommendations for completing the form accurately.

Provide patient information:

Fill in the patient's full name, date of birth, and any other identifying information requested. It's essential to double-check the accuracy of these details to avoid any confusion or delays in the testing process.

Specify the requesting physician:

Indicate the name and contact information (phone number, address, etc.) of the physician who is requesting the tumor cytogenomics analysis. This information allows the laboratory to contact the physician if needed or provide the test results accurately.

Document the referring institution or facility:

If applicable, provide the name and address of the medical institution or facility referring the patient for the tumor cytogenomics laboratory testing. Including this information helps ensure proper communication between the laboratory, physician, and referring facility.

Include clinical history and relevant information:

This section is crucial for providing context to the laboratory regarding the patient's medical history, previous diagnoses, treatments, and any other information that may guide the analysis or interpretation of the test results. Be as detailed as possible to assist the laboratory in comprehensively assessing the patient's condition.

Specify the type of sample:

Indicate the type of sample being submitted for analysis, such as a tumor biopsy, blood sample, or other relevant specimens. Providing accurate information allows the laboratory to handle and process the sample appropriately.

Document any specific test requests:

If there are any specific genetic tests or analyses requested, clearly state them in this section. This may include chromosomal analysis, fluorescence in situ hybridization (FISH), or any other specialized testing required for the patient's diagnosis or treatment planning.

Include insurance and billing information:

If necessary, fill in the patient or insurance billing details as requested on the form. This section may require the patient's insurance information, including policy number, group number, or any other relevant details for billing purposes.

Who Needs Tumor Cytogenomics Laboratory Requisition:

1. Oncologists: Oncologists often request tumor cytogenomics laboratory requisitions when diagnosing or monitoring cancer patients. It helps in understanding the genetic abnormalities or chromosomal variations present in the tumor cells, aiding treatment decisions.
2. Pathologists: Pathologists may use tumor cytogenomics laboratory requisitions to further analyze tissue samples and precisely characterize different types of tumors at the molecular level. The results obtained through cytogenomics can assist in providing accurate diagnoses and guiding treatment strategies.
3. Geneticists and Genetic Counselors: These professionals may often request tumor cytogenomics testing to evaluate the genetic predisposition or hereditary factors associated with certain types of tumors. This information is beneficial in assessing the patient's potential risk or guiding counseling regarding family planning or genetic counseling.
4. Researchers: Researchers in the field of oncology and genetics may also require tumor cytogenomics laboratory requisitions for their studies. By analyzing genetic abnormalities in tumors, researchers can gain insights into the underlying mechanisms driving cancer development and progression.

Please note that the specific individuals who need tumor cytogenomics laboratory requisitions may vary depending on the institutional practices, patient needs, and the goals of the testing.

For pdfFiller’s FAQs

What is tumor cytogenomics laboratory requisition?

Tumor cytogenomics laboratory requisition is a form or request submitted to a laboratory for the analysis and evaluation of the genetic makeup of a tumor.

Who is required to file tumor cytogenomics laboratory requisition?

Medical professionals or researchers involved in studying and diagnosing tumors are required to file tumor cytogenomics laboratory requisition.

How to fill out tumor cytogenomics laboratory requisition?

Tumor cytogenomics laboratory requisition can be filled out by providing detailed information about the patient, the suspected tumor, and the reason for the genetic analysis.

What is the purpose of tumor cytogenomics laboratory requisition?

The purpose of tumor cytogenomics laboratory requisition is to provide insights into the genetic abnormalities of a tumor, which can help in diagnosis, prognosis, and treatment planning.

What information must be reported on tumor cytogenomics laboratory requisition?

Information such as patient demographics, medical history, tumor location, suspected genetic abnormalities, and the requesting physician's details must be reported on tumor cytogenomics laboratory requisition.

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