Anatomic pathology request form 2025

1. Click ‘Get Form’ to open the anatomic pathology request form in the editor.
2. Begin by filling out the 'Requestor(s)' section. Enter the requesting clinician's name, patient health number (PHN), and location for report delivery. You can use a stamp or label for convenience.
3. Complete the 'Patient' section with the patient's last name, first name, middle initial, address, date of birth, gender, city/town, and postal code.
4. If applicable, indicate any priority status in the designated field and provide a clinical reason. For critical cases, ensure to contact the pathologist directly.
5. Fill in details about the tissue removed including who performed the procedure, their contact information, and date collected.
6. In 'Clinical Information / History', provide relevant medical history and current problems. This section is crucial for accurate diagnosis.
7. List all samples under 'Sample(s) / Tissue(s)', ensuring that labels match requisition details. Specify anatomical sites and any special handling requests.

Start using our platform today to streamline your document editing and form completion process for free!