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Filling in the laboratory
request forms
Information on the request forms must be
filled in correctly as this will be used for identification of the patient
and requester, location of patient, examination to be performed, billing
and interpretation of result in the context of clinical information
provided. The fields in the
request forms are:
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Group
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Field Name
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Comment
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Patient Demographics
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Name (full name as
on identifying document, surname first)
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These fields are
used to identify the sample to the patient. 2 unique identifiers are required.
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HKID/Passport
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Sex/Age
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Date of Birth (DD/MM/YYYY)
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Race
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Location of Patient
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Hospital/Clinic
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Hospital/Clinic
No
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Ward
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Accounting Info
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Class
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Bill To
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Requester Info
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Report To
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Clinical Info
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Nature of
Specimen
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Previous
cytology/path no.
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Clinical
History/Diagnosis
LMP and hormonal status
information are required for interpretation of pap smear
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Surgical
procedure & specimen submitted
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Date of request (DD/MM/YYYY)
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Doctor (full name,
surname first)
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Below are samples of form for histology and cytology examinations (Form F01-V11) and form for pap smear testing (Form F02-V9).
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