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Cytology requisition form

Dynacare cytology pdf 2026

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4.8 out of 5

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The document is a Cytology Requisition form used for laboratory testing, detailing patient and clinician information, specimen collection details, and specific tests requested. It includes sections for patient history, clinical status, and certification by the clinician. The form emphasizes the importance of providing relevant clinical information for accurate test interpretation and notes that patients will be billed for certain tests.

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Click ‘Get Form’ to open the dynacare cytology PDF in the editor.
Begin by filling in the 'Requisitioning Clinics / Practitioner' section. Enter the name, address, and contact number for urgent results.
Next, provide the patient's information including Health Card Number, CPSO/Registration Number, Service Date, and Date of Birth. Ensure all details match the health card.
In the 'Specimen Collection' section, specify the collection date and time. Select the appropriate site and method for specimen collection.
Complete any relevant clinical history or remarks that may assist in interpreting test results. This is crucial for accurate analysis.
Finally, ensure that a Clinician/Practitioner signature is provided at the bottom of the form before submission.

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Versions	Form popularity	Fillable & printable
2018	4.8 Satisfied (60 Votes)
2017	4.3 Satisfied (48 Votes)
2015	4.1 Satisfied (66 Votes)
2013	4.4 Satisfied (57 Votes)

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