Checklist for Medical Records

Oncology Medical Records Guideline:

HX Oncology Consultation:

☐ 1-2 Office Visit Notes from all Providers listed on the Intake form
☐ Any recent laboratory studies
(Recent and historical labs pertaining to diagnosis)
☐ Pathology and Operative Notes (Path and Op are different reports)
☐ Radiology- CAT Scan
☐ Any Genetic Testing
☐ ANY Hospital Discharges (Within 6 months)

Myeloma Consultation:

☐ 1-2 Office Visit Notes from all Providers listed on the Intake form
☐ All recent Lab Studies (CBC/CMP, Creatinine, Calcium, Free, Light Chains, SPEP, SIEP, QlgS (3-5 Years) 24-hr urine for total protein and UIEP, ESR, B2M) ☐ Pathology/Operative- Bone Marrow Biopsy Report (Ask Pt. if done)
☐ Radiology: Extent of disease studies (if done): X-Ray Reports, CT of Chest/Abd/Pelvis, PET, MRI ☐ ANY Hospital Discharges (Within 6 months)

Colon Cancer Consultations:

☐ 1-2 Office Visit Notes from all Providers listed on the Intake form
☐ Baseline tumor markers (if done) CEA, CA 19-9
☐ Colonoscopy report with Pathology Report
(PDL1\MSI\KRAS/NRAS\BRAF) and Op Note
☐ Radiology: Extent of disease studies (if done): Chest
x- ray or CT abdomen/pelvis/MRI
☐ ANY Hospital Discharges (Within 6 months)

Prostate Consultations:

☐ 1-2 Office Visit Notes from all Providers listed on the
Intake form
☐ All prostate biopsy reports
☐ Radiation Oncology Reports (Seed implant Report)-
Initial Consultation
☐ Extent of disease studies (if done):
☐ Cystoscopy report, Transrectal ultrasound report
(TRUS), Bone scan, CAT Scans
☐ Baseline tumor markers (if done), PSA, CBC, CMP
(2-3 Years)
☐ Urology Consultation- Initial Consultation
☐ ANY Hospital Discharges (Within 6 months)

Breast Cancer Consultation:

☐ 1-2 Office Visit Notes from all Providers listed on the Intake form (Make sure we get Notes by Surgeon)
☐ Any recent laboratory studies
☐ Genetic Testing
☐ Pathology and Operative Reports: Initial Bx, Lumpectomy/ Mastectomy ☐ ER/PR, HER2(done by IHC or FISH) Histologic Grade, Oncotype DX/MammaPrint (Check with Surgeons office most likely Oncotype was done) ☐ Radiology: Screening Mammogram and Diagnostic Mammogram Ultrasound w/ BX, MRI of the Breast ☐ ANY Hospital Discharges (Within 6 months)

Leukemia Consultations:

☐ 1-2 Office Visit Notes from all Providers listed on the Intake form
☐ All recent laboratory studies (especially CBC/Diff, CMP, BMPS hx of 2-3Years)
☐ Pathology/Operative- Bone Marrow Biopsy Report (if done or call Pt) and Flow Cytometry
☐ Radiology (if done): Chest x-ray, CAT Scans
☐ ANY Hospital Discharges (Within 6 months)

Lymphoma Consultations:

☐ 1-2 Office Visit Notes from all Providers listed on the Intake form
☐ All recent laboratory studies (especially LDH, CBC, CMP, uric acid, ESR, B2M, SPEP)
☐ Pathology/Operative: Biopsy Report (Usually Lymph Node Biopsy) Review of biopsy if any
☐ Extent of disease studies-RADIOLOGY (if done): Chest X-Ray, PET/CAT
☐ ANY Hospital Discharges (Within 6 months)

Lung Consultations:

☐ 1-2 Office Visit Notes from all Providers listed on the Intake form
☐ Bronchoscopy report with pathology report & bronchial washing cytology or fine needle aspiration biopsy report (CT guided)
or fine needle aspiration biopsy report (Molecular Profile\EFGR\ALK\ROS\PDLl)
☐ Baseline tumor marker studies (if done): CEA
☐ Radiology: CAT Scans, Chest X-Rays
CT of abdomen/pelvis/brain, Bone scan
☐ ANY Hospital Discharges (Within 6 months)