Get Histocompatibility Lab Testing Requisition Form - University Of Utah ... - Healthcare Utah

Filling out the Histocompatibility Lab Testing Requisition Form is essential for submitting test samples and ensuring accurate lab results. This guide provides step-by-step instructions on how to navigate and complete this form online.

Follow the steps to successfully complete the requisition form.

1. Click ‘Get Form’ button to access the form and open it in your selected editor.
2. Complete the requester information section by providing your name, phone number, location, and today's date.
3. Fill in the sample date, ensuring it matches the date on the sample tube. This date is crucial for lab tracking.
4. In the patient demographics section, provide full details of the person tested, including their name, date of birth, sex, race, medical record number (MRN), social security number (SSN), hospital name, physician's name, and any additional required information.
5. Specify the transplant type by marking the appropriate option: autologous bone marrow transplant (autoBMT), allogeneic bone marrow transplant (alloBMT), or the specific organ involved.
6. Indicate any testing requirements, making sure to select the necessary tests such as HLA typing or crossmatching, and include relevant details like whether the sample is STAT or routine.
7. If there are any special studies or other tests required, clearly outline these in the miscellaneous section.
8. Review all filled information for accuracy and completeness, as incomplete forms can lead to delays or refusal of testing.
9. Once you are satisfied with the form, save your changes. You can also choose to download, print, or share the completed form as needed.

Complete your Histocompatibility Lab Testing Requisition Form online to ensure timely and accurate testing.