Follow the steps to fill out the form correctly.

1. Click ‘Get Form’ button to obtain the form and open it for editing.
2. Enter the requisitioning clinic or practitioner's name and address clearly. This ensures the correct provider is associated with the specimen.
3. Provide the clinician or practitioner's contact number for urgent results, ensuring there is a direct line for any critical communication.
4. Fill in the health card number, CPSO or registration number, and the service date using the required format.
5. Enter the patient's information including their last name, first name, middle name, date of birth, address, and health card expiry date. Ensure accuracy as this data is critical for identification.
6. Select the appropriate sex option for the patient and check any relevant boxes concerning the type of cytology (e.g., gynecologic or non-gynecologic).
7. Complete the fields for specimen collection date, time, and method of collection by marking any options that apply (e.g., brush, broom).
8. Fill out the clinical history or remarks section with any relevant patient history that may aid in the evaluation.
9. Have the clinician/practitioner sign the form to certify the tests ordered are not for registered in or out patients of a hospital.
10. Review all entries for accuracy, then save changes, download the completed form, or print it for your records.

Complete your documentation by filling out the Canada Dynacare QSP 1401A online now.