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Clinical Laboratories AT TIME OF REQUEST FAX FORM(S) TO SURGICAL PATHOLOGY AT (608) 2627174. TURNAROUND TIME IS 37 DAYS. Patient Name: ___600 Highland Ave., Madison WI 537922472 (608) 2637060Principal
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01
Fill out the patient's demographic information including name, date of birth, and medical record number.
02
Specify the details of the requested tissue sample including the type of tissue, date of collection, and any relevant clinical information.
03
Indicate the reason for the tissue request and provide any additional comments or instructions.
04
Sign and date the request form to confirm the accuracy of the information provided.

Who needs uwhc-surgical-pathology-archived-tissue-request?

01
Medical professionals such as pathologists, researchers, or clinicians who require archived tissue samples for diagnostic or research purposes.
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The uwhc-surgical-pathology-archived-tissue-request is a formal process to request archived tissue specimens from the surgical pathology department at UW Health for diagnostic or research purposes.
Medical professionals, researchers, or institutions seeking access to archived surgical pathology specimens are required to file the request.
To fill out the request, include patient identifiers, specify the type of tissue needed, provide the purpose of the request, and sign the form to confirm authorization.
The purpose is to facilitate access to preserved tissue samples for diagnosis, forensic investigation, or academic research, ensuring proper handling and consent.
Required information includes patient name, medical record number, date of collection, type of tissue requested, purpose of the request, and institutional affiliation.
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