Patient Identification-Requisition

Requisitions are supplied by Ada West Dermatopathology (AWD) to all providers and should include the following information:

• Patient Name
• Patient MRN (Medical Record Number) or EMA (Electronic Medical Assistant) ID
• Patient Sex
• Patient DOB
• Patient Address
• Patient Insurance/Billing Information
• Source of Specimen (location)
• Procedure (i.e. type of biopsy)
• Clinical Information or History
• Orientation Information (Stitch, Suture etc.)
• Physician Name and Address
• Specimen Collection Date
• Date of Service

Specimen Collection and Handling

• Specimen collection is performed in the examination rooms by the providers. The specimen must be labeled and requisition prepared in the room where the surgical procedure is performed.
• Specimens should be handled promptly and not be subject to extreme heat or cold.
• Every effort should be made to get the specimen into the formalin bottle as quickly as possible. AWD lab supplies all its clients with pre-filled formalin containers (20 or 40 ml bottles).
• Clinicians should use caution when placing the specimen in the formalin. Personal Protective Equipment (PPE) should be used to avoid skin contact with formalin. If formalin does come in contact with skin, immediately wash with soap and plenty of water.
• The ratio of formalin to specimen should be 20:1. It is the responsibility of the clinician to judge this ratio and monitor adherence to this policy. It may be necessary to add formalin to the bottle to meet the ratio. For large specimens it may be necessary to use a bottle other than those supplied by the lab. In these cases it is the offices responsibility to make sure the container is water tight and formalin resistant.

Specimen Labeling

• Every specimen bottle sent or brought to AWD must be labeled
• Containers themselves rather than lids should be labeled as lids can loosen
• The container must have two patient identifiers (name and DOB, SSN, medical record number or control number)
• The specimen container must be labeled with a formalin warning sticker

Specimen Transportation

• All specimens must have an accompanying fully completed requisition
• Formalin containers must be placed a biohazard specimen bag (these are provided for free by AWD)
• We have complimentary courier services to pick up and deliver specimens to our lab and offer complimentary FedEx/UPS services as needed

Direct Immunofluorescence (DIF) Instructions

• Specimens submitted for DIF evaluation should be placed in Michel’s
  Solution.
• Michel’s Solution containers are provided by AWD

Frozen Section Specimen Instructions

• Frozen section specimens need to be sent to the lab fresh (unfixed)
• Do NOT place specimens removed for frozen section evaluation in formalin
• It is suggested that if a long delay is expected, the specimen should be covered with saline soaked gauze to prevent the tissue from drying out
• Frozen section specimens need all the above requisition information submitted with them, along with orientation information (suture/stitch) so the lab can properly ink and orient the specimen

• Supply Order Form [use this form to order more free supplies for your lab]
• Formalin Safety Data Sheet