Cytology request form 2026

1. Click ‘Get Form’ to open the cytology request form in the editor.
2. Begin by entering the 'Date received' and 'Accession #' at the top of the form. This information is crucial for tracking your specimen.
3. Fill in the 'Patient Information' section, including the patient's last name, first name, PHIN, and date of birth. Ensure that all details match those on the specimen vial.
4. Complete the 'Patient History' section by providing dates for the last normal menses, last Pap test, and any previous abnormal tests. Indicate if the patient is pregnant or menopausal.
5. In 'Previous Treatment', check any applicable treatments such as colposcopy or laser. This helps provide context for current testing.
6. Specify 'Specimen Preparation' methods used and indicate if a hysterectomy has occurred.
7. Fill out 'Provider Information', ensuring to include your designation and contact details accurately for billing purposes.

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