Jpc Form 543 PDF Details

We've all been there: You need to fill out a new form and have no idea where to start. It can be daunting, especially when it comes to complex government forms like Jpc Form 543. Fortunately, with careful preparation and the right information, you can navigate the complexities of this document with relative ease. In this blog post, we'll outline what is included in Jpc Form 543 along with steps on how to correctly complete and submit it for processing. Keep reading for more advice on tackling this important task!

QuestionAnswer
Form NameJpc Form 543
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesform543 online form fill for jpc

Form Preview Example

JOINT PATHOLOGY CENTER

ATTN: Registry Submissions

606 Stephen Sitter Avenue

Silver Spring, MD 20910-1258

JOINT PATHOLOGY CENTER (JPC) REGISTRY SUBMISSION ACKNOWLEDGEMENT AND RECEIPT

PAGE ___ OF

____PAGES

Please be advised that no histopathological review will be conducted by the JPC for these submissions. JPC policy is to provide such review only when expressly requested using a JPC Contributor's Consultation Request Form. If you have any questions regarding the status of a case, please contact JPC Customer Services at jpchelp@amedd.army.mil via encrypted email or call toll free at 1-855-393-3904.

DO NOT USE FOR CONSULTATION.

1. CONTRIBUTOR (Facility Name, Address)

 

 

 

2.

CONTACT NUMBERS

 

3. SUBMITTED (Date)

 

4. RECEIVED (Date)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2a. PHONE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2b. FAX

 

 

 

 

 

 

 

 

 

5a. PATIENT NAME (Last, First, MI)

5b. SSN

6. CONTRIBUTOR’S

7. MATERIALS SENT (Quantity)

8. REGISTRY

 

9.

 

10. JPC

 

 

11. JPC ACCESSION

 

 

(Last Four)

ACCESSION NUMBER

 

 

(POW, AGO,

 

RECEIVED

 

COMMENTS

 

 

NUMBER

 

 

 

 

 

KUW, IRQ,

( X one)

7a.

7b.

7c.

7d.

AFG, etc.)

 

 

PATH/CYTOL

GLASS

PARAFFIN

WET

 

Y

N

REPORT

SLIDES

BLOCKS

TISSUE

 

 

 

JPC FORM 543, DEC 2011

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How one can fill out Jpc Form 543 part 1

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Writing section 2 in Jpc Form 543

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