UPMC Solid Tumor Test Requisition 2022-2025 free printable template

MAP Laboratory Shipping Address: Molecular & Genomic Pathology Laboratory 3477 Euler Way, Room 8026 Pittsburgh, PA 15213 Phone: (412) 8646162 FAX: (412) 8646163DIVISION OF MOLECULAR & GENOMIC PATHOLOGY (To

How to fill out division genomic pathology solid tumor requisition form

How to fill out UPMC Solid Tumor Test Requisition

1. Obtain the UPMC Solid Tumor Test Requisition form from the UPMC website or your healthcare provider.
2. Fill in the patient's full name, date of birth, and medical record number at the top of the form.
3. Provide the patient's contact information, including address and phone number.
4. Indicate the physician's name and contact information, including address and phone number.
5. Specify the reason for the test and any relevant clinical information in the designated section.
6. Check the appropriate box for the type of solid tumor test being requested.
7. Include any additional information or notes that may be necessary for the laboratory.
8. Review the completed requisition for accuracy.
9. Sign and date the requisition where indicated.
10. Submit the requisition along with the patient sample as instructed.

Who needs UPMC Solid Tumor Test Requisition?

1. Patients suspected of having a solid tumor based on clinical evaluation.
2. Oncologists and healthcare providers who require testing for diagnosis or treatment planning of solid tumors.
3. Clinical laboratories that need the requisition for processing solid tumor tests.

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What is UPMC Solid Tumor Test Requisition?

UPMC Solid Tumor Test Requisition is a form used to request testing and analysis of solid tumors to guide diagnosis, treatment, and management of cancer.

Who is required to file UPMC Solid Tumor Test Requisition?

Healthcare providers, such as physicians or oncologists, are required to file the UPMC Solid Tumor Test Requisition for their patients suspected of having solid tumors.

How to fill out UPMC Solid Tumor Test Requisition?

To fill out the UPMC Solid Tumor Test Requisition, one must provide patient details, clinical information, specimen type, and any relevant medical history that supports the testing request.

What is the purpose of UPMC Solid Tumor Test Requisition?

The purpose of the UPMC Solid Tumor Test Requisition is to formally request laboratory testing that helps in diagnosing cancer, determining treatment options, and monitoring the effectiveness of ongoing treatment.

What information must be reported on UPMC Solid Tumor Test Requisition?

The requisition must report patient demographics, clinical information, specimen details, insurance information, and the specific tests requested.