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How to use or fill out CYTOGENETIC REQUISITION Patient Information OTHER THAN
- Begin by clearly printing your name in the designated 'Name' section, including both surname and first name.
- Fill in your address accurately to ensure proper communication. This is crucial for any follow-up regarding your requisition.
- Enter your date of birth in the format DD/MM/YY, and select your sex by marking either 'M' or 'F'.
- Provide your health card number as this information is mandatory for processing the specimen.
- Complete the 'Ordering Physician' section with the physician's surname and first name who is requesting the test.
- Indicate whether the sample is routine or urgent, and if applicable, provide details about any pregnancy at risk.
- Specify the testing requested by checking appropriate boxes and providing clinical indications where necessary.
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2013 | 4 Satisfied (22 Votes) |
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