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CYTOLOGY GYNECOLOGIC TEST REQUISITION2119 E. 93rd / L15 Cleveland, OH 44106 216.444.5755 or 800.628.6816FORM_CLIENT INFORMATIONPATIENT INFORMATION (PLEASE PRINT IN BLACK INK) ___ Last NameFirstMI

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How to fill out cytology non-gynecologic test requisition

01

Begin by providing patient demographics including name, date of birth, and ID number.

02

Indicate the type of specimen being submitted (e.g. sputum, urine, fine needle aspirate).

03

Include the source of the specimen (e.g. lung, bladder, lymph node).

04

Provide relevant clinical history and reason for the test.

05

Fill out the ordering physician information including name and contact details.

06

Make sure to sign and date the requisition form before submitting.

Who needs cytology non-gynecologic test requisition?

01

Medical professionals such as physicians, pathologists, and other healthcare providers who suspect non-gynecologic abnormalities in their patients.

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What is cytology non-gynecologic test requisition?

The cytology non-gynecologic test requisition is a standard form used to request laboratory analysis of cellular samples from non-gynecologic sites, such as the respiratory or gastrointestinal tracts.

Who is required to file cytology non-gynecologic test requisition?

Healthcare providers, including physicians and other qualified practitioners, are required to file the cytology non-gynecologic test requisition when they order cytology tests for their patients.

How to fill out cytology non-gynecologic test requisition?

To fill out the requisition, a healthcare provider must include patient information, test type, clinical history, the source of the specimen, and any specific instructions relevant to the test.

What is the purpose of cytology non-gynecologic test requisition?

The purpose of the cytology non-gynecologic test requisition is to formally request the evaluation of cellular specimens to diagnose diseases, monitor conditions, or guide treatment decisions in non-gynecologic contexts.

What information must be reported on cytology non-gynecologic test requisition?

The requisition must report patient demographics, specimen source, clinical indications, and any additional relevant medical history that may assist in the interpretation of the results.

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