University of Utah Health Histocompatibility Testing Requisiton 2019-2025 free printable template

Reset FormHISTOCOMPATIBILITY TESTING REQUISITION Registration card imprint or patient demographicsHistocompatibility & Immunogenetics Laboratory CIA# 46D0679773 417 Jakarta Way, Suite 3220 Salt Lake

How to fill out histocompatibility testing requisition

How to fill out University of Utah Health Histocompatibility Testing Requisiton

1. Begin by entering the patient's full name in the designated field.
2. Fill in the patient's date of birth and medical record number.
3. Specify the testing type required by selecting from the provided options.
4. Include the ordering physician's name and contact information for follow-up.
5. Indicate the reason for the test in the designated section.
6. Ensure all insurance information is complete and accurate, if applicable.
7. Review the requisition form for any errors before submission.
8. Print or digitally submit the requisition to the University of Utah Health laboratory.

Who needs University of Utah Health Histocompatibility Testing Requisiton?

1. Patients undergoing organ transplants who require compatibility testing.
2. Individuals with a history of autoimmune diseases needing specialized testing.
3. Patients enrolled in clinical trials that require histocompatibility testing.
4. Family members of organ donors needing compatibility evaluation.

People Also Ask about

What does HLA lab stand for?

HLA stands for human leukocyte antigens. HLA are proteins—or markers—on most cells in your body. Your immune system uses HLA to see which cells belong in your body and which do not.

What is the importance of histocompatibility testing?

Blood Type and Histocompatibility Likewise, histocompatibility testing is performed to help identify recipient/donor combinations that would result in poor allograft survival. Both donor and recipient HLA-A, HLA-B, and HLA-DR antigens of the major histocompatibility complex are determined.

How does HLA matching work?

What is HLA matching? When two people share the same HumanLeukocyte Antigens (abbreviated as HLA), they are said to be a "match", that is, their tissues are immunologically compatible with each other. HLA are proteins that are located on the surface of the white blood cells and other tissues in the body.

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What is University of Utah Health Histocompatibility Testing Requisition?

The University of Utah Health Histocompatibility Testing Requisition is a formal document used to request histocompatibility testing, which is essential for matching organ and tissue donors with recipients to minimize the risk of rejection.

Who is required to file University of Utah Health Histocompatibility Testing Requisition?

Healthcare providers, such as doctors or transplant coordinators, are required to file the University of Utah Health Histocompatibility Testing Requisition on behalf of patients requiring histocompatibility testing.

How to fill out University of Utah Health Histocompatibility Testing Requisition?

To fill out the University of Utah Health Histocompatibility Testing Requisition, a healthcare provider must complete all required fields including patient demographics, clinical information, test request information, and any necessary signatures.

What is the purpose of University of Utah Health Histocompatibility Testing Requisition?

The purpose of the University of Utah Health Histocompatibility Testing Requisition is to facilitate accurate and efficient testing of tissue compatibility, ensuring the best possible outcomes for organ and tissue transplant patients.

What information must be reported on University of Utah Health Histocompatibility Testing Requisition?

The information that must be reported includes patient identification details, clinical history, specific tests being requested, and relevant medical provider information.