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Get Mayo Clinic Pathology Consultation
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How to fill out the Mayo Clinic Pathology Consultation online
The Mayo Clinic Pathology Consultation form is essential for initiating a pathology case review. This guide provides comprehensive instructions on accurately completing the form online to ensure a smooth consultation process.
Follow the steps to complete the consultation form efficiently.
- Press the 'Get Form' button to obtain the form and open it in your preferred editing tool.
- Fill in the required patient information, including the last name, first name, middle name, date of birth (formatted as mm/dd/yyyy), gender, and the last four digits of the Social Security Number. Note that the Social Security Number is only for identification purposes.
- Provide details for the case information section. Include up to three case numbers, the accession number, the specimen source, the date of collection or procedure, the number of slides or blocks, and the number of CDs being submitted.
- Complete the referring physician and institution information by entering the last name, first name, institution name, preferred phone number, office or lab phone number, fax number, and mailing address.
- If the return of material institution is different from the referring physician's institution, specify the institution name and mailing address here.
- If additional reports need to be faxed to other physicians, include their names and fax numbers in the designated area.
- Indicate the responsible billing party. If applicable, check the box that notes whether the billing party is the same as the referring physician, and provide details if utilizing Medicare or Medicaid.
- Verify the shipping address and ensure it reads: Mayo Clinic in Arizona, Department of Pathology, 13400 E Shea Blvd, Scottsdale, AZ 85259.
- Once all required fields are filled in, review the form for completeness and accuracy. Users can then save their changes, download the document for records, print it out for mailing, or share it as needed.
Complete your Mayo Clinic Pathology Consultation form online today to ensure timely review of your case.
A clinical pathology consultation is a service rendered by the pathologist in response to a request from an attending physician in relation to a test result(s) requiring additional medial interpretive judgment.