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Robert W. Doms, M.D., Ph.D., PathologistinChiefCORE LABORATORY: HEMATOLOGY REQUISITION PATIENT NAME:SEX:MFDate: ___ Diagnosis/ICD10: ___MR:Ordering Physician/CRNP: ___AGE/ DATE OF BIRTH:Ordering Location:
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How to fill out immunohistochemistry-requisition-form
How to fill out immunohistochemistry-requisition-form
01
Obtain the immunohistochemistry requisition form from the laboratory or medical facility.
02
Fill in the patient's personal information, including name, date of birth, and medical record number.
03
Indicate the physician's details, including name, contact information, and signature.
04
Specify the type of specimen being submitted (e.g., biopsy, surgical resection).
05
Clearly mark the tests requested for immunohistochemistry analysis.
06
Provide clinical history relevant to the specimen, including any previous diagnoses or treatments.
07
Sign and date the form to validate the request.
08
Submit the completed form along with the specimen to the laboratory.
Who needs immunohistochemistry-requisition-form?
01
Pathologists requiring tissue analysis for diagnosis.
02
Oncologists assessing cancer type and treatment options.
03
Surgeons seeking to understand the nature of a tumor.
04
Researchers conducting studies involving tissue samples.
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What is immunohistochemistry-requisition-form?
The immunohistochemistry-requisition-form is a document used by healthcare professionals to request immunohistochemical testing on tissue samples for diagnostic purposes.
Who is required to file immunohistochemistry-requisition-form?
Healthcare providers, such as doctors and pathologists, are required to file the immunohistochemistry-requisition-form when ordering immunohistochemical tests.
How to fill out immunohistochemistry-requisition-form?
To fill out the immunohistochemistry-requisition-form, include patient demographics, clinical information, the specific tests requested, and the source of the tissue sample.
What is the purpose of immunohistochemistry-requisition-form?
The purpose of the immunohistochemistry-requisition-form is to formally request and document laboratory testing for accurate diagnosis and treatment planning.
What information must be reported on immunohistochemistry-requisition-form?
Required information includes patient name, date of birth, physician's details, clinical history, specific tests needed, and any relevant sample information.
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