Loading
Get Colposcopy & Treatment Form
How it works
-
Open form follow the instructions
-
Easily sign the form with your finger
-
Send filled & signed form or save
How to fill out the COLPOSCOPY & TREATMENT FORM online
Filling out the COLPOSCOPY & TREATMENT FORM online is an essential step for individuals undergoing cervical screening procedures. This guide provides you with clear instructions to help you complete the form accurately and efficiently.
Follow the steps to complete the form smoothly.
- Press the 'Get Form' button to access the COLPOSCOPY & TREATMENT FORM and open it in your online editor.
- Begin filling in the patient details section. Provide your Medicare number, family name, given names, date of birth, street address, suburb, state, and postcode. Ensure that all information is accurate and written in BLOCK LETTERS.
- Next, complete the colposcopist details. Include the provider number, clinic name, colposcopist's family name, and given names.
- Record the date of the colposcopy by selecting the correct day, month, and year.
- Choose the primary indications for the colposcopy by selecting one option. Options include new patient with an abnormal cervical screening test, symptomatic, or other specified conditions.
- Indicate the adequacy of the colposcopy in the next field. Select either 'Adequate' or 'Inadequate' based on the definitions provided in the form.
- Specify the type of transformation zone (TZ) visibility observed during the procedure by selecting the appropriate type from the options provided.
- Fill in the primary colposcopy impression by selecting one option regarding your condition post-opacity.
- Indicate if the patient was pregnant at the time of the colposcopy by selecting 'Yes' or 'No.'
- If a biopsy or treatment was performed during this episode, please indicate 'Yes' or 'No' for each question.
- Complete the treatment details sections if applicable. Select the excision type and modality/method used for treatment, and indicate the location where the treatment was performed.
- Once you have finished filling out all sections, save any changes made to the form. You may then choose to download, print, or share the completed form.
Complete your form online today to ensure timely processing and assistance.
Get form
Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.
A colposcopy is nearly pain-free. You might feel pressure when the speculum goes in. It might also sting or burn a little when they wash your cervix with the vinegar-like solution. If you get a biopsy, you might have some discomfort.
Get This Form Now!
Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
Industry-leading security and compliance
US Legal Forms protects your data by complying with industry-specific security standards.
-
In businnes since 199725+ years providing professional legal documents.
-
Accredited businessGuarantees that a business meets BBB accreditation standards in the US and Canada.
-
Secured by BraintreeValidated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.