Get the free 2015 Cytogenetics Requisition Formxlsx - labmedx ucsfmedicalcenter

Patient Information: Medical Genomics Cytogenetics Laboratory Last Name 185 Berry St, Ste 290, Rm 2421 San Francisco, CA 94107 Phone: 4153534844 Fax: 4153534877 First Name Date of Birth MI Male Female

How to fill out 2015 cytogenetics requisition formxlsx

How to fill out 2015 cytogenetics requisition formxlsx:

1. Start by entering the necessary personal information in the provided fields. This may include your name, address, date of birth, and contact information.
2. Next, indicate the reason for the cytogenetics requisition form by selecting the appropriate checkbox or filling in the necessary details. This could be for diagnostic purposes, follow-up testing, or research.
3. If applicable, provide the name and details of the referring physician or healthcare provider who ordered the test.
4. Specify the specimen details by indicating the type of sample being submitted (e.g., blood, tissue, bone marrow) and the date it was collected.
5. Fill in any relevant clinical information that may aid in the interpretation of the test results. This could include the patient's medical history, symptoms, or any relevant medications.
6. Indicate the specific tests or analyses that are being requested by selecting the appropriate checkboxes or filling in the necessary information.
7. If necessary, provide any additional instructions or information that the laboratory should be aware of regarding the specimen or testing process.
8. Sign and date the form to confirm your authorization and understanding of the information provided.

Who needs 2015 cytogenetics requisition formxlsx:

1. Individuals who have been recommended by their healthcare provider to undergo cytogenetic testing.
2. Patients who are experiencing certain symptoms or conditions that may require further investigation through cytogenetic analysis.
3. Researchers or scientists who are conducting studies or experiments that involve cytogenetics and require sample analysis.

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