Get the free Surgical Pathology Requisition Form

William P. Clements, Jr. University Hospital Anatomic Pathology Clinical Laboratory Services pH: (214)6336393 Fax : (214)6338700 6201 Harry Hines Blvd, Suite UH04.426, Dallas, TX 75390 CIA#45D0665307

How to fill out surgical pathology requisition form

How to fill out a surgical pathology requisition form:

1. Start by entering the patient's personal information, including their full name, date of birth, and contact information. This ensures accurate identification and communication throughout the process.
2. Next, provide information about the referring physician, including their name, contact details, and any relevant affiliations. This helps establish a clear line of communication between the pathologist and the referring physician.
3. Indicate the type of specimen being submitted for pathology analysis. Specify whether it is a tissue biopsy, excisional specimen, or any other type of sample. Accurate categorization of the specimen ensures appropriate analysis methods are employed.
4. Include relevant clinical information about the patient's condition, symptoms, medical history, and any pertinent findings from previous diagnostic tests. This information provides context to the pathologist for more accurate interpretation of the results.
5. Specify the requested tests or procedures to be performed on the submitted specimen. Different tests may require different handling and analysis techniques, so be as specific as possible in your request.
6. Provide the reason for the pathology analysis. This could include confirming a diagnosis, guiding treatment decisions, or evaluating disease progression. Clearly articulate the intended purpose to ensure the pathologist focuses on the most relevant aspects.
7. Indicate the required turnaround time for the results. While this may vary depending on the urgency of the situation, it is crucial to communicate any time constraints to the pathologist.
8. Finally, ensure that all necessary signatures are obtained, both from the referring physician and the patient, if applicable. This confirms consent for the analysis and verifies the accuracy of the provided information.

Who needs a surgical pathology requisition form?

A surgical pathology requisition form is typically required for patients undergoing a surgical procedure that involves the removal of tissue or organs. This form is generally used by surgeons, referring physicians, and other healthcare professionals involved in the diagnosis and treatment of the patient. It is essential for ensuring effective communication between the referring physician, the pathologist, and the laboratory conducting the analysis. By providing relevant clinical information and indicating the necessary tests, the surgical pathology requisition form aids in accurate diagnosis and guides appropriate treatment decisions for the patient.

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What is surgical pathology requisition form?

The surgical pathology requisition form is a document used to request a pathology examination on tissue specimens obtained during surgery.

Who is required to file surgical pathology requisition form?

Surgeons or healthcare providers who have obtained tissue specimens during surgery are required to file the surgical pathology requisition form.

How to fill out surgical pathology requisition form?

The surgical pathology requisition form should be filled out with the patient's information, specimen details, clinical history, and the reason for the pathology examination.

What is the purpose of surgical pathology requisition form?

The purpose of the surgical pathology requisition form is to ensure that the correct pathology examination is conducted on the tissue specimens obtained during surgery.

What information must be reported on surgical pathology requisition form?

The surgical pathology requisition form must include the patient's name, date of birth, medical record number, specimen type, collection date, clinical history, and the requesting physician's information.