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UPMC Solid Tumor Test Requisition 2013 free printable template

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MAP Laboratory Shipping Address: Molecular & Genomic Pathology Laboratory 3477 Euler Way, Room 8026 Pittsburgh, PA 15213 Phone (412) 8646162 FAX: (412) 8646163 DIVISION OF MOLECULAR & GENOMIC PATHOLOGY
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How to fill out UPMC Solid Tumor Test Requisition

01
Obtain the UPMC Solid Tumor Test Requisition form from the appropriate source.
02
Fill in patient demographic information, including name, date of birth, and contact details.
03
Provide the referring physician's details, including name, contact number, and address.
04
Select the specific tests required from the list provided on the requisition form.
05
Include the patient's medical history and relevant clinical information to assist in test interpretation.
06
Sign and date the form to confirm the request and authorization.
07
Submit the completed requisition form along with the specimen to the designated laboratory or testing facility.

Who needs UPMC Solid Tumor Test Requisition?

01
Patients with suspected or diagnosed solid tumors requiring diagnostic testing.
02
Oncologists and healthcare providers needing to request solid tumor analysis for treatment planning.
03
Research institutions conducting studies involving solid tumors.
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The UPMC Solid Tumor Test Requisition is a form used to request testing for solid tumors, facilitating the collection of necessary information for laboratory analysis.
Healthcare providers, such as physicians and oncologists, are required to file the UPMC Solid Tumor Test Requisition on behalf of their patients.
To fill out the UPMC Solid Tumor Test Requisition, providers must complete sections including patient information, clinical history, test requested, and signature of the healthcare provider.
The purpose of the UPMC Solid Tumor Test Requisition is to ensure accurate and efficient processing of laboratory tests related to solid tumors, aiding in diagnosis and treatment planning.
The requisition must report patient demographics, relevant clinical information, the specific test being requested, and the provider's contact details.
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