Get the free CYTOGENETICS REQUISITION

4001 Leslie Street, 3SE Toronto, ON M2K 1E1 Tel: (416) 7566240 Fax: (416) 7564729 www.nygh.on.ca/genetics/labs Collected by Date NIGH Patient: Out In CYTOGENETICS REQUISITION PATIENT INFORMATION Ward

How to fill out cytogenetics requisition

How to Fill out Cytogenetics Requisition:

1. Start by providing your personal information, including your name, date of birth, and contact details. Make sure all the information is accurate and up-to-date.
2. Next, provide your healthcare provider's information, including the name of the referring physician, their contact information, as well as the clinic or hospital where they practice.
3. Indicate the reason for the cytogenetics requisition. This could include indications such as suspected genetic disorders, prenatal testing, or cancer diagnostics, among others.
4. Specify the type of specimen being submitted for analysis. This could include blood, bone marrow, amniotic fluid, or any other relevant body tissue. Provide details on how the sample was collected, as this can impact the testing process.
5. Include any relevant clinical information or medical history that may assist the cytogenetics laboratory in interpreting the results accurately. This could include information about family history, previous genetic testing, or any specific symptoms or concerns.
6. If applicable, mention any specific tests or techniques you would like the laboratory to perform, or if you have any specific questions or concerns that you would like to address through the testing.
7. Review the requisition form thoroughly for accuracy and completeness before submitting it. Make sure all the necessary signatures are duly provided, including your own signature and the signature of the healthcare provider.
8. Finally, follow the instructions provided by your healthcare provider or the laboratory on how to submit the requisition form. This may involve mailing the form, hand-delivering it, or submitting it electronically, depending on the specific requirements of the laboratory.

Who needs cytogenetics requisition?

1. Individuals with suspected genetic disorders who require genetic testing to confirm a diagnosis or aid in treatment decisions.
2. Pregnant women seeking prenatal testing to assess the risk of genetic disorders or chromosomal abnormalities.
3. Individuals with cancer or hematological disorders who may benefit from cytogenetic analysis to guide treatment options or monitor disease progression.
4. Couples undergoing infertility treatment who may require genetic testing to assess the risk of passing on genetic conditions to their offspring.
5. Individuals with a family history of genetic disorders who may want to determine their own risk or assess the risk to their children.
6. Patients with unexplained developmental delays, intellectual disabilities, or birth defects where a genetic cause is suspected.
7. Researchers conducting studies or clinical trials that require cytogenetic analysis to evaluate the impact of genetic factors on disease outcomes.

For pdfFiller’s FAQs

What is cytogenetics requisition?

Cytogenetics requisition is a form or request submitted to a laboratory for cytogenetic testing, which involves the study of chromosomes in relation to health and disease.

Who is required to file cytogenetics requisition?

Cytogenetics requisition is typically filed by healthcare professionals such as doctors, genetic counselors, or other specialists.

How to fill out cytogenetics requisition?

Cytogenetics requisition can be filled out by providing patient information, reason for testing, relevant medical history, and any specific instructions.

What is the purpose of cytogenetics requisition?

The purpose of cytogenetics requisition is to request cytogenetic testing to diagnose or monitor genetic disorders, birth defects, or certain types of cancer.

What information must be reported on cytogenetics requisition?

Information such as patient demographics, clinical indications, test(s) requested, relevant family history, and any additional notes should be reported on cytogenetics requisition.

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