Get Completed Alberta Colposcopy Report Form Request - Screeningforlife

This guide provides clear instructions on how to complete the Completed Alberta Colposcopy Report Form Request - Screeningforlife online. Follow the steps carefully to ensure that all required information is accurately provided.

Follow the steps to successfully complete the form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. In the 'Clinic Requesting Report' section, enter the name of the clinic in the designated field. Include the clinic's telephone number and fax number to ensure proper communication.
3. Provide the contact person's name. This should be the individual responsible for the request.
4. Input the name of the requesting physician to establish accountability and follow-up.
5. In the 'Patient Information' section, fill in the last name and first name of the patient for whom the report is requested.
6. Enter the Alberta health care number of the patient, which is essential for identification within the health system.
7. Indicate the date of the colposcopy exam. This should be entered in the format of year, month, and day.
8. Specify the colposcopy clinic where the exam was conducted to provide additional context.
9. Ensure the form is signed to authenticate the request. This signature is crucial for processing the request.
10. After completing the form, fax the finished document to the provided fax number (403-355-3289) to submit your request.

Start filling out the Completed Alberta Colposcopy Report Form Request online today!