CA CHLA OncoKids Test Requisition free printable template
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Shinto: DepartmentofPathologyandLaboratoryMedicine ChildrensHospitalLosAngeles 4650SunsetBlvd. DuqueBldg.,2ndFloor,Room2290 Los Angeles,CA90027ChildrensHospitalLosAngeles Alexander. Judging, MD DepartmentofPathology&LaboratoryMedicine
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How to fill out patient information reporting information
How to fill out CA CHLA OncoKids Test Requisition
01
Obtain the CA CHLA OncoKids Test Requisition form from the official website or healthcare provider.
02
Fill out patient information including name, date of birth, and medical record number.
03
Provide detailed clinical history and the reason for testing under the relevant section.
04
Include the ordering physician's information, including name, contact number, and signature.
05
Indicate the specific tests requested on the form.
06
Ensure that all required consents are signed by the guardian or parent if the patient is a minor.
07
Review the completed form for accuracy before submission.
08
Send the requisition form along with the samples as instructed.
Who needs CA CHLA OncoKids Test Requisition?
01
Patients with suspected genetic disorders or malignancies.
02
Oncologists and medical professionals seeking genetic testing for personalized medicine.
03
Clinicians involved in pediatric oncology requiring molecular profiling for treatment decisions.
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What is CA CHLA OncoKids Test Requisition?
The CA CHLA OncoKids Test Requisition is a form used to request genetic testing for pediatric patients suspected of having cancer. This requisition is part of the OncoKids program at Children's Hospital Los Angeles, which focuses on identifying genetic mutations that can inform treatment options for children with cancer.
Who is required to file CA CHLA OncoKids Test Requisition?
The CA CHLA OncoKids Test Requisition must be filed by healthcare providers, typically physicians or oncologists, who are managing the care of pediatric patients with suspected or confirmed cancer diagnoses.
How to fill out CA CHLA OncoKids Test Requisition?
To fill out the CA CHLA OncoKids Test Requisition, providers need to complete sections detailing patient information, clinical history, relevant medical conditions, and the specific tests requested. It's important to sign and date the form, ensuring all provided information is accurate and complete.
What is the purpose of CA CHLA OncoKids Test Requisition?
The purpose of the CA CHLA OncoKids Test Requisition is to facilitate genetic testing that helps identify specific mutations or genetic alterations in pediatric cancers, which can guide diagnosis, treatment decisions, and prognostic evaluations.
What information must be reported on CA CHLA OncoKids Test Requisition?
The information that must be reported on the CA CHLA OncoKids Test Requisition includes the patient's full name, date of birth, medical record number, clinical diagnosis, test requested, family history related to cancer, and the healthcare provider's information and signature.
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