4Cyte Pathology - Direct Download

Order Copy of Specified Patient Results

Complete this form to request pathology results for up to 10 specified patients to be sent via fax or simultaneously downloaded to a treating medical practitioner’s practice management system.

Upon submission of this online form, 4Cyte will within 15 minutes, fax or download the specified patient(s) results to the treating doctor’s pre-registered practice management system held on file by 4Cyte.

Provider Number

Doctor Last Name

Doctor Email (if emailed confirmation of download / fax request required)

I confirm that:

I am the original referring doctor

I am NOT the original referring doctor, but I am a treating doctor

I request download / fax of all pathology reports issued by 4Cyte Pathology on the patient(s) specified below:

Send the results to me through:

Download

Fax

Download / Fax reports for the specified patient(s) for the selected period:

First Name

Patient Date Of Birth

First 6 Digits Of Medicare Number

Order Copy of Specified Patient Results

Download / Fax to Doctor:

Download / Fax Results for Period:

Download / Fax results for following Specified Patient(s):