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Health Record #: ___ Complete or place barcoded
patient label here
Patient Name: (Print first, last)___dd mm by
DOB: ___/___/___596 Davis Drive
Newmarket, ON L3Y 2P9Age: ___q Females Malachi #:___Version
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How to fill out pathology requisition
How to fill out pathology requisition
01
Obtain the required pathology requisition form from the healthcare provider.
02
Fill in the patient's demographics, including name, date of birth, and any other relevant information.
03
Provide details of the tests or procedures requested by the healthcare provider.
04
Include relevant clinical information, such as symptoms, medical history, and any other pertinent details.
05
Ensure the form is signed and dated by the healthcare provider requesting the tests.
06
Submit the completed pathology requisition form to the designated laboratory for processing.
Who needs pathology requisition?
01
Healthcare providers such as doctors, nurse practitioners, and physician assistants who require diagnostic testing for their patients.
02
Patients may also need a pathology requisition if they are seeking specific tests or procedures recommended by their healthcare provider.
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What is pathology requisition?
Pathology requisition is a form or document used to request specific tests or procedures to be performed on a patient's sample.
Who is required to file pathology requisition?
Pathology requisition is typically filed by healthcare providers such as doctors, nurses, or laboratory technicians.
How to fill out pathology requisition?
Pathology requisition is filled out by providing patient information, test requests, and any relevant clinical details.
What is the purpose of pathology requisition?
The purpose of pathology requisition is to ensure proper testing and analysis of patient samples for diagnostic or monitoring purposes.
What information must be reported on pathology requisition?
Pathology requisition must include patient demographics, test requests, ordering healthcare provider information, and relevant clinical details.
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