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GENETIC DIAGNOSTIC LABORATORY UNIVERSITY OF PENNSYLVANIA SCHOOL OF MEDICINE DEPARTMENT OF GENETICS 415 Anatomy Chemistry Building 3620 Hamilton Walk Philadelphia, PA 19104 Tel: (215) 5739161 Fax:
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How to fill out request for retinoblastoma testing
How to fill out request for retinoblastoma testing
01
Obtain the necessary request form from the medical facility or laboratory where the retinoblastoma testing will be conducted.
02
Fill out the patient's personal information accurately, including their name, date of birth, and contact details.
03
Provide the relevant medical history of the patient, including any previous diagnoses or treatments related to retinoblastoma.
04
Specify the reason for the requested testing, such as suspected retinoblastoma symptoms or family history of the disease.
05
Indicate the type of retinoblastoma testing that is being requested, whether it's genetic testing or the examination of eye tissue samples.
06
Include any additional supporting documentation or reports that may be relevant to the retinoblastoma testing request.
07
Sign and date the request form, ensuring that all information provided is accurate and complete.
08
Submit the filled-out request form to the relevant medical facility or laboratory as per their specific instructions.
Who needs request for retinoblastoma testing?
01
Anyone suspected of having retinoblastoma or with a family history of the disease may need to request retinoblastoma testing.
02
This includes individuals who exhibit symptoms such as a white or cloudy pupil, crossed eyes, vision problems, or abnormal eye movements.
03
Furthermore, individuals with a family history of retinoblastoma, especially parents or siblings of affected individuals, should consider requesting testing.
04
Early detection and diagnosis of retinoblastoma through testing is crucial for timely treatment and improved outcomes.
05
It is advisable to consult with a healthcare professional or specialist to determine if a request for retinoblastoma testing is necessary.
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What is request for retinoblastoma testing?
A request for retinoblastoma testing is a formal application submitted to obtain genetic testing for retinoblastoma, a type of eye cancer that primarily affects children.
Who is required to file request for retinoblastoma testing?
Typically, healthcare professionals, such as pediatricians or oncologists, are required to file the request for retinoblastoma testing on behalf of patients, often with parental consent.
How to fill out request for retinoblastoma testing?
To fill out the request, the healthcare provider must provide detailed patient information, medical history, and the specific tests being requested, ensuring all fields are completed accurately.
What is the purpose of request for retinoblastoma testing?
The purpose is to identify the presence of genetic mutations associated with retinoblastoma, enabling early diagnosis and intervention for affected individuals.
What information must be reported on request for retinoblastoma testing?
The request must include patient identification details, clinical history, reason for testing, and the specific tests requested, along with relevant family history if applicable.
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