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Requisitions & Forms

Requisition Forms

CytoGenX has developed a test requisition form to ensure medically appropriate test ordering and to meet the information requirements of federal and private healthcare programs. Completion of the client, patient, and billing sections is mandatory, as well as the clinical information sections (ICD-10). This information is essential for accurate specimen processing, diagnosis coding, and billing.

Informed Consent

It is mandatory for the ordering physician to obtain informed consent from the patient prior to any testing. The physician must sign the requisition form to confirm that informed consent has been obtained.

Ordering Policies

All testing conducted at CytoGenX must be requested by an “authorized person”—someone legally permitted under state law to order tests or receive test results, or both.

Changing/Supplementing Orders

After a specimen is received at CytoGenX, the ordering physician may request additional testing or cancel previously ordered tests. Such requests can be made via telephone, fax, or email. CytoGenX will document the request and may seek written confirmation from the ordering physician.