UPMC Solid Tumor Test Requisition 2019 free printable template

MAP Laboratory Shipping Address: Molecular & Genomic Pathology Laboratory 3477 Euler Way, Room 8026 Pittsburgh, PA 15213 Phone: (412) 8646162 FAX: (412) 8646163DIVISION OF MOLECULAR & GENOMIC PATHOLOGY

How to fill out UPMC Solid Tumor Test Requisition

How to fill out UPMC Solid Tumor Test Requisition

1. Obtain the UPMC Solid Tumor Test Requisition form from the designated medical facility or download it from the UPMC website.
2. Fill in the patient's personal details including name, date of birth, and medical record number.
3. Provide the referring physician's information including name, contact number, and address.
4. Indicate the specific test(s) required under the 'Tests Requested' section.
5. Complete the diagnosis or clinical information section to give context for the testing.
6. Ensure all required fields are filled out completely and accurately.
7. Sign and date the requisition form as the authorized provider submitting the request.
8. Attach any necessary additional documents or previous test results as required.
9. Submit the requisition form along with the specimen as per UPMC guidelines.

Who needs UPMC Solid Tumor Test Requisition?

1. The UPMC Solid Tumor Test Requisition is required for patients who have a solid tumor or suspected solid tumor that needs further evaluation through laboratory testing.
2. Oncologists and healthcare providers who are managing the treatment of patients diagnosed with solid tumors also need this requisition to ensure proper testing.

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What is UPMC Solid Tumor Test Requisition?

The UPMC Solid Tumor Test Requisition is a form used to request testing of solid tumor samples for diagnostic, prognostic, or treatment guidance purposes. It facilitates the collection and processing of specimens within the UPMC healthcare system.

Who is required to file UPMC Solid Tumor Test Requisition?

Healthcare providers, including physicians and medical professionals, who are submitting solid tumor specimens for testing are required to file the UPMC Solid Tumor Test Requisition.

How to fill out UPMC Solid Tumor Test Requisition?

To fill out the UPMC Solid Tumor Test Requisition, complete all required fields including patient information, specimen type, clinical history, and any relevant diagnostic codes. Ensure that the information is accurate and legible.

What is the purpose of UPMC Solid Tumor Test Requisition?

The purpose of the UPMC Solid Tumor Test Requisition is to provide necessary information for the accurate testing and analysis of solid tumor specimens, aiding in patient diagnosis and management.

What information must be reported on UPMC Solid Tumor Test Requisition?

The UPMC Solid Tumor Test Requisition must report patient demographics (such as name, date of birth, and medical record number), submitting physician details, specimen type, clinical information, testing requested, and relevant history or diagnostic codes.