Cytology custom requisition forms are used by providers when requesting medical testing of individual cells or clusters, often for cancers.
Cytology custom integrated label forms are used by physicians to examine a patient's cells to determine the risk of abnormalities or cancer..
An acceptable cytology request form must accompany specimen containers and include the following: Patient's name, medical record number, date of birth, sex, source (exact location and procedure used), date specimen was taken, name of ordering physician and pager number..
Complete a cytopathology test request form (in preprinted paper form or test order printed from Epic). 8.
Send labeled specimen vial and completed request form to the laboratory for processing.
No refrigeration of the specimen is necessary. 9.
On-line video available:
Requests for Services.
All requests for Services must be submitted to Pathology on a Pathology Reference Laboratory Service Request form.
Specimens must be properly prepared and packaged for shipment or transport, as applicable, in accordance with all federal, state, and local laws.
Neuropathology [only] Slides, Block, and Tissue Service Form Fees.
Record the patient information and medical history on the cytology request form.
Place the vial and requisition in a specimen bag for transport to the laboratory.
Unlabeled vials or requisition form will be rejected and physician office will be notified.
All vials must be submitted without collection device (broom/spatula/brush).
Our cytology services include:
