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Appendix B: Contributor's Consultation Request Form Joint Pathology Center
Pages 141-144

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From page 141...
... when the committee completed its work in mid-2012. The form is dated 03/30/2011.
From page 142...
... : LAST NAME FIRST MIDDLE INITIAL RACE American Indian or Alaskan Native Asian or Pacific Islander DATE OF BIRTH AGE SOCIAL SECURITY NO. Black White Unknown Month: Day: Year: SEX: Male Female ETHNICITY Hispanic Not of Hispanic Origin MATERIALS FORWARDED FIXATIVE (Required)
From page 143...
... Clinical or gross photos, pertinent X-rays, CT scans, MRI scans, echograms, angiograms, and similar diagnostic studies add substantially to the education value of the case. They are highly desired by some departments and required by others.

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