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SURGICAL PATHOLOGY REQUISITIONDepartment of PathologyPATIENT INFORMATION (or affix patient label) LAST NAMEFIRST NAME, LABORATORY USE ONLY**ATTACH PATIENT BILLING INFORMATION (REQUIRED) SEX SSN STREET

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How to fill out surgical pathology consultation request

01

Obtain the necessary form from the pathology department or website.

02

Fill out the patient's demographic information including name, date of birth, and medical record number.

03

Provide detailed clinical history including reason for consultation and relevant lab and imaging results.

04

Specify the type of specimen being submitted and any special instructions.

05

Include contact information for the referring physician in case of questions or additional information needed.

06

Submit the completed form along with the specimen to the pathology department.

Who needs surgical pathology consultation request?

01

Patients who require specialized evaluation of tissue samples or biopsies.

02

Physicians who are looking for a second opinion on a pathology diagnosis.

03

Researchers who need expertise in interpreting complex pathology results.

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What is surgical pathology consultation request?

Surgical pathology consultation request is a formal request made by a healthcare provider to seek expert opinion from a pathologist on a specific case or specimen.

Who is required to file surgical pathology consultation request?

Healthcare providers such as physicians, surgeons, or other medical professionals who require additional insights on a pathological diagnosis may file a surgical pathology consultation request.

How to fill out surgical pathology consultation request?

To fill out a surgical pathology consultation request, the healthcare provider must provide pertinent patient information, clinical history, relevant imaging studies, and specific questions for the pathologist.

What is the purpose of surgical pathology consultation request?

The purpose of a surgical pathology consultation request is to obtain a second opinion or expert guidance on a challenging or complex case to ensure accurate diagnosis and appropriate patient management.

What information must be reported on surgical pathology consultation request?

The surgical pathology consultation request must include patient demographics, clinical history, relevant laboratory results, imaging studies, previous pathology reports (if available), and specific questions for the consulting pathologist.

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