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                Get Cytogenetic Laboratories Constitutional (blood) Test Requisition Form 2015
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How to use or fill out the Cytogenetic Laboratories Constitutional (Blood) Test Requisition Form online
Filling out the Cytogenetic Laboratories Constitutional (Blood) Test Requisition Form online is a straightforward process. This guide will provide you with step-by-step instructions to ensure that you complete each section accurately and efficiently.
Follow the steps to complete the requisition form effectively.
- Press the ‘Get Form’ button to obtain the requisition form and open it for editing.
- Begin with the 'Physician(s)' section. Enter the naming details of the ordering physician, including the signature and contact information, as well as the primary physician's details.
- In the 'Patient Information' section, fill out the patient's name, address, medical record number, date of birth, gender, and pregnancy status.
- Move on to the 'Clinical Information' section. Provide the collection date, collection time, the collector's name, and recent transfusion status.
- Next, complete the 'Referring Diagnoses' section by checking all relevant diagnoses that apply to the patient and including any ICD-10 codes where necessary.
- Proceed to 'Requested Testing' and select the appropriate tests being requested based on patient needs. Ensure you provide any required blood type and volume.
- If microdeletion FISH analysis is requested, select the relevant options provided and ensure clarity on the selected probes.
- Complete the 'Patient Financial Authorization/Insurance Benefit Verification' section by signing and providing necessary insurance details, followed by the healthcare provider's information.
- Fill in the 'Specimen Collection Requirements' and 'Specimen Handling Requirements' to ensure proper guidelines are followed for the testing.
- Finally, review all entries for accuracy. Once complete, you can save your changes, download, print, or share the completed form.
Start completing your documents online today to ensure a smooth submission process.
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        A laboratory request form must include essential information like patient details, physician’s contact, and the type of test requested. For a Cytogenetic Laboratories Constitutional (Blood) Test Requisition Form, it's vital to articulate any clinical indications effectively. Ensuring this information is complete helps laboratories prioritize and process tests accurately and efficiently.
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