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CLEAR FORM Gynecologic Surgical Pathology requisition Laboratory Use Only1 2 3 4 NameRequesting Clinician/Practitioner Clinician/Practitioner Phone NumberAddressHealth Card Number (HAN) Provincetown
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How to fill out gynecologic surgical pathology requisition
How to fill out gynecologic surgical pathology requisition
01
Step 1: Begin by gathering all necessary information and materials such as the patient's demographic and medical history, surgical pathology requisition form, and any relevant diagnostic test results.
02
Step 2: Ensure that the patient's information is accurately filled out on the requisition form, including their full name, date of birth, and medical record number.
03
Step 3: Indicate the specific reason for the gynecologic surgical pathology requisition, such as a suspected malignancy or evaluation of abnormal tissue.
04
Step 4: Provide details about the surgical procedure being performed, including the date, location, and type of surgery.
05
Step 5: Specify any particular areas or organs of interest to be examined by the pathologist, if applicable.
06
Step 6: Include information about any preoperative interventions, such as previous biopsies or treatments, that may impact the interpretation of the pathology results.
07
Step 7: If applicable, list any specific questions or concerns that the healthcare provider would like the pathology report to address.
08
Step 8: Ensure that the requisition form is signed and dated by the ordering healthcare provider before submitting it to the pathology laboratory for processing.
09
Step 9: Double-check all information to ensure accuracy and completeness before sending the requisition form.
10
Step 10: Send the completed gynecologic surgical pathology requisition form along with any supporting documents to the designated pathology laboratory.
Who needs gynecologic surgical pathology requisition?
01
Gynecologic surgical pathology requisition is needed by healthcare providers, specifically gynecologists, who are performing or overseeing surgical procedures related to gynecologic conditions.
02
Pathologists also require the gynecologic surgical pathology requisition to properly process and interpret tissues and specimens obtained during gynecologic surgical procedures.
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What is gynecologic surgical pathology requisition?
Gynecologic surgical pathology requisition is a form used to request the examination of tissue samples from gynecologic surgeries for diagnostic purposes.
Who is required to file gynecologic surgical pathology requisition?
The surgeon or healthcare provider who performed the gynecologic surgery is required to file the requisition.
How to fill out gynecologic surgical pathology requisition?
The requisition must be completed with patient information, surgical details, and specific instructions for pathology examination.
What is the purpose of gynecologic surgical pathology requisition?
The purpose of the requisition is to ensure the proper examination of tissue samples to provide accurate diagnosis and treatment recommendations.
What information must be reported on gynecologic surgical pathology requisition?
Patient demographics, surgical procedure details, specimen description, clinical history, and any specific requests for pathology examination.
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