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Office Use OnlyFRMVDC018 1.0VETERINARY DIAGNOSTIC CENTERSurgical Pathology Submission Form Mailing Address: P.O. Box 82646 Lincoln, NE 685012646Accession NumberPhone: (402) 4721434 Fax: (402) 4723094 Email:

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How to fill out surgical pathology submission form

01

Gather all relevant patient information including name, date of birth, medical history, and reason for surgery.

02

Fill out the top section of the form with patient demographics and contact information.

03

Provide detailed information about the specimen being submitted, including location of the tissue sample and any relevant clinical history.

04

Indicate any special instructions for processing the specimen, such as fixation or staining preferences.

05

Sign and date the form to certify the accuracy of the information provided.

Who needs surgical pathology submission form?

01

Surgeons

02

Pathologists

03

Medical facilities

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What is surgical pathology submission form?

The surgical pathology submission form is a document used by healthcare providers to submit tissue specimens for pathological examination and diagnosis.

Who is required to file surgical pathology submission form?

Healthcare professionals, such as surgeons and pathologists, who perform surgical procedures that involve tissue removal are required to file the surgical pathology submission form.

How to fill out surgical pathology submission form?

To fill out the surgical pathology submission form, list the patient's demographic information, provide details about the specimen, indicate the clinical history, and ensure all required signatures are included.

What is the purpose of surgical pathology submission form?

The purpose of the surgical pathology submission form is to provide essential information to assist pathologists in diagnosing diseases and conditions based on the submitted tissue specimens.

What information must be reported on surgical pathology submission form?

The form must report patient identification, specimen type, clinical history, referring physician's information, and any relevant procedures performed.

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