Get the free Cytogenetics Laboratory Requisition Form - Kingston General Hospital

Accession: For MEL Laboratory Use only Test Requisition Form This form must accompany all specimens received Billing instructions are available on page 5 All specimens received must include two patient

How to fill out cytogenetics laboratory requisition form

How to fill out cytogenetics laboratory requisition form

1. Step 1: Begin by entering the patient's information, such as name, date of birth, and unique identifier.
2. Step 2: Specify the source of the sample, whether it is blood, bone marrow, or tissue.
3. Step 3: Provide the reason for the cytogenetic analysis. This could include suspected genetic disorders or chromosomal abnormalities.
4. Step 4: Indicate the type of test requested, such as karyotyping, fluorescence in situ hybridization (FISH), or chromosomal microarray analysis (CMA).
5. Step 5: Include clinical information that may be relevant to the analysis, such as symptoms, previous test results, or family history.
6. Step 6: Mention any specific instructions or additional requirements for the laboratory.
7. Step 7: Sign and date the requisition form, indicating your agreement to the terms and conditions.
8. Step 8: Submit the completed form along with the sample to the cytogenetics laboratory for processing.

Who needs cytogenetics laboratory requisition form?

1. Cytogenetics laboratory requisition forms are typically needed by medical professionals, such as doctors, genetic counselors, and researchers, who require cytogenetic analysis for their patients.
2. These forms are essential for ordering specific tests and providing necessary information to the cytogenetics laboratory to assist in diagnosing genetic disorders or determining chromosomal abnormalities.

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