A requisition form must accompany the specimen to the laboratory.
- It is important to print the patient's first and last name on the tissue request form. If the patient goes by a nickname, use the patient’s formal name. Also include the patient’s date of birth, sex, and date of the surgery/procedure.
- Complete the patient history and clinical findings in the provided space. Note previous biopsies done on that site. Identify suture markers.
- Any special requests should be noted on the request form (e.g. "Please call results ASAP”).
- Complete the insurance information, including Medicare, patient's address, and phone number.
- Please include the following information on the request form to ensure accurate specimen preparation, interpretation, result reporting, and billing.
Exclusion of any of the following information may result in specimen rejection and/or processing delays.
- Patient’s complete name, address, date of birth, sex, and social security number.
- Specimen source
- Date specimen was obtained
- Pertinent clinical information
- Insurance name and policy number
- Physicians’ complete name (first and last) and the complete name of any physicians requiring copies of the report.
