Histopathology request form sample: Fill out & sign online

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Click ‘Get Form’ to open the histopathology request form in the editor.
Begin by entering the requisitioning clinic or practitioner's name and address in the designated fields. Ensure accuracy for effective communication.
Fill in the clinician/practitioner’s contact number for urgent results, along with their CPSO/Registration Number and Health Card Number.
Provide patient details including last name, first name, middle name, date of birth, sex, and health card expiry date. Make sure all information matches the health card.
Indicate the type of biopsy being performed (e.g., excision, shave) and specify the anatomic site of biopsy. Include any clinical history that may assist in diagnosis.
Complete the specimen collection details such as date, time, and whether it was placed in 10% NBF. Ensure to check if these times differ.
Finally, have the clinician/practitioner sign where indicated to validate the request before submission.

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How can I eSign my histopathology requisition form from Gmail?

With DocHub, it’s pretty simple. The editor offers users an add-on called DocHub for Gmail, which you can locate in the Google Workspace Marketplace without being charged. Install it and give it access to your Google account. Open your email with your histopathology requisition form attached and click on the add-on button in the right-side panel. Log in to your DocHub account, and upload the file to our editor, where you can complete it and sign.

How to manage my histopathology form from Gmail?

If your go-to electronic mail service is Gmail, you can easily integrate your DocHub editor in your work. Edit your histopathology form with DocHub tools and attach it to your drafts in Gmail. See how easy it can be to exchange files and collaborate with a swift PDF editing solution at hand.