Get Anatomic Pathology Request Form 2020-2025

Filling out the Anatomic Pathology Request Form online is a straightforward process that ensures accurate and efficient handling of pathological samples. This guide will provide you with step-by-step instructions to complete the form correctly.

Follow the steps to complete the Anatomic Pathology Request Form accurately.

1. Click ‘Get Form’ button to access the Anatomic Pathology Request Form in your preferred online editor.
2. Fill in the requestor(s) section, including the last and first names, personal health number (PHN), and location or code and address for the report. If applicable, use a stamp or label for convenience.
3. Provide the patient's information, including their last name, first name, middle initial, address, city/town, province, postal code, date of birth (formatted as yyyy-Mon-dd), and gender.
4. Indicate if the request is other than routine and explain the priority clinical reason if it is. For critical cases, remember to contact the pathologist directly.
5. In the section labeled 'Tissue Removed by,' enter the names, locations, phone, and fax numbers for those involved in tissue collection.
6. Record the date the sample was collected (formatted as yyyy-Mon-dd) and the accession number, which is for lab use only.
7. If you want copies of the report sent to other parties, fill out their names, locations, and contact information in the 'Copy to' section.
8. Fill in the date and time the sample was received, using the format yyyy-Mon-dd,hh:mm.
9. Provide clinical information and history by detailing the current problems, differential diagnosis, and any relevant medical or family history.
10. List all samples or tissues, including their IDs, anatomical sites, organ of origin, and collection procedures while ensuring the sample labels match the requisition.
11. Specify any special assessments required, such as cytogenetics, electron microscopy, or molecular pathology, and remember to detail any special handling procedures.
12. For intraoperative consultations, indicate the type of consultation and include the name of the pathologist or designee.
13. Finally, review all information for accuracy, make any necessary corrections, and then save your changes, download, print, or share the completed form as needed.

Complete your Anatomic Pathology Request Form online today for efficient processing.