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Cytology request form 2026
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- Click ‘Get Form’ to open the cytology request form in the editor.
- Begin by entering the 'Date received' and 'Accession #' at the top of the form. This information is crucial for tracking your specimen.
- 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.
- 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.
- In 'Previous Treatment', check any applicable treatments such as colposcopy or laser. This helps provide context for current testing.
- Specify 'Specimen Preparation' methods used and indicate if a hysterectomy has occurred.
- Fill out 'Provider Information', ensuring to include your designation and contact details accurately for billing purposes.
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All specimens must be accompanied by a preprinted Cytopathology Request Form or a printed Epic order. The form must contain all pertinent data
by M Peters 1989 New cervical cytology request form is unusable. Full text PDF Page 598 598. PDF (306.4 KB)