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Cervical cytology request form

New cervical cytology request form is unusable 2026

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The document is a Cervical Cytology Request Form used for submitting specimens to various cytology laboratories in Manitoba, Canada. It includes sections for patient information, history, specimen preparation, and collector details, ensuring proper identification and billing for cervical cancer screening tests.

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Click ‘Get Form’ to open the New cervical cytology request form in our editor.
Begin by entering the Accession # and Date received in the designated fields. Ensure these are accurate for proper tracking.
Fill in the Specimen collection date, ensuring it follows the format (dd/mmm/yyyy). This is crucial for record-keeping.
In the PATIENT INFORMATION section, input the patient's Last name, First name, and PHIN. Remember that matching PHIN and names on the vial is required.
Complete additional patient history details such as Last normal menses, Date of birth, and Gender. Mark any relevant options like Pregnant or Menopausal.
For PREVIOUS TREATMENT, check any applicable treatments like Colposcopy or Laser. Provide dates where necessary.
In SPECIMEN PREPARATION, select between Liquid based cytology or Conventional cytology based on your procedure.
Finally, fill out SPECIMEN COLLECTOR INFORMATION with your designation and contact details to ensure proper billing and reporting.

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Versions	Form popularity	Fillable & printable
2024	4.6 Satisfied (22 Votes)
2015	4 Satisfied (59 Votes)

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Why would a smear test be rejected?

Cervical cytology samples must satisfy minimum requirements and any errors that compromise the safety of the patient will result in the sample being rejected.

What happens if a smear test comes back abnormal?

If the cells are abnormal, you will be referred for a test called to colposcopy. If you tested positive for HPV, but your cytology results were normal, you will be invited back for a test in a year.

Would cervical cancer show up on a smear test?

The Pap test and HPV test are screening tests, not diagnostic tests. They cannot tell for certain if you have cervical cancer. An abnormal Pap test or HPV test result may mean more testing is needed to see if a cancer or a pre-cancer is present.

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What causes an unsatisfactory smear in cytology?

Tips for Best Practice on Unsatisfactory Cytology A number of factors can contribute to this outcome, including atrophy, poor or improper collection technique, obscuring inflammation, poor slide preparation, presence of blood, excessive lubricant in the specimen, and increased thickness of the smear.

What is the main reason for an unsatisfactory smear?

The reason for this could be obscuration of more than 75% of the cells by mucus, inflammatory cells, or by blood. Low squamous cellularity was the most common cause of unsatisfactory smears in all age groups in the study by Garza et al.