What information is required on the requisition form?
All specimens must be properly labeled and have a complete and accurate requisition. The following information is requested on the Summit Pathology requisition form:
- Patient's full name
- Date of birth
- Complete address
- Medical record number (for hospital patients)
- SSN
- Submitting physician
- Other physicians who should receive a copy of the report
- Date of specimen collection
- Appropriate clinical history (see below)
- ICD-9 code
- Site of specimen (be specific!)
- Any special studies requested
- Insurance information (may be copied front and back and attached to requisition)
If any information is missing, Summit Pathology personnel will call the office to obtain the information, but this may lead to delays in processing the specimen.
Please note that you may use a single requisition for multiple biopsy specimens, even when the biopsies were obtained during separate procedures on the same day (for example, an upper endoscopy and lower endoscopy on the same patient on the same day). Simply complete the requisition, listing each biopsy separately by site.
Please remember that a biopsy is a consultation (just like a radiology exam or an infectious disease consultation), and the more history that is provided to the pathologist, the better he is able to synthesize that history with what is present on the slides. We sometimes hear people say that they don't want to "bias" the pathologist to a particular diagnosis by giving "too much" history. The truth is that the more information submitted, the better the pathologist is able to interpret what is present on the slide in the context of the patient's clinical situation.