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Clinical Directorate of Laboratory Medicine, Beaumont Hospital Doc No: HAEMCLF023 Revision 6 Active Date 06/05/2022 INHERITED THROMBOPHILIA SCREEN / LUPUS ANTICOAGULANT SCREEN REQUEST FORM All sections
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How to fill out uhw thrombophilia lupus request

01
Obtain the UHW Thrombophilia Lupus request form from the appropriate department.
02
Fill in the patient's personal information including name, date of birth, and medical record number.
03
Indicate the reason for the request and provide any relevant medical history.
04
Specify the type of tests needed for Thrombophilia and Lupus screening.
05
Ensure all sections of the form are completed accurately and legibly.
06
Submit the completed request form to the designated lab or department for processing.

Who needs uhw thrombophilia lupus request?

01
Patients who have symptoms or risk factors for thrombophilia or lupus.
02
Healthcare providers who suspect a patient may have thrombophilia or lupus and require diagnostic testing.
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The uhw thrombophilia lupus request is a form used to request testing for thrombophilia lupus.
Healthcare providers are required to file the uhw thrombophilia lupus request on behalf of their patients.
The uhw thrombophilia lupus request form can be filled out by providing patient information, relevant medical history, and reason for testing.
The purpose of the uhw thrombophilia lupus request is to determine if a patient has thrombophilia lupus, a condition that increases the risk of blood clots.
The uhw thrombophilia lupus request must include patient demographics, medical history, symptoms, and any relevant diagnostic tests.
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