자궁경부암 검진 결과통보서

자궁경부암 검진 결과통보서

별 첨

성 명 주민등록번호 - 1(2) * * * * * *

구 분 검 사 항 목

(검진일) 결 과 판 정

※ 판정구분에 따라 판정기준을 그대로 기입

자 궁 경 부 암

자궁경부 세포검사 ( 년 월 일)

유형별진단 (세포진단)

�※ 검체부적절일 경우 해당 없음

권 고 사 항

판정일 년 월 일 판정의사 면허번호

의사명 (서명)

자궁경부암 검진 결과통보서

※ (건강보험가입자) 건강검진 결과통보서상 상급종합병원에서의 요양급여가 필요하다는 의사 소견이 기재된 경우, 요양급여의뢰서(진 료의뢰서)로 갈음되며 본 통보서를 활용하여 상급종합병원에서 진료를 받으실 수 있습니다.

※ (의료급여수급권자) 건강검진 결과 이상소견이 발견되어 진료담당의사가 검진결과서에 추가 진료가 필요하다는 의사소견을 기재한 경우 동 검진결과서를 의료급여의뢰서로 갈음하여 검진을 실시한 의료급여기관에서 진료를 받으실 수 있습니다. 그 이외의 의료급 여가 필요한 경우에는「의료급여법 시행규칙」제3조의 의료급여절차에 따라 진료를 받으셔야 하며, 선택의료급여기관 적용 대상자는 본인이 선택한 의료급여기관에서 먼저 진료를 받으셔야 합니다.

※ 자궁경부암은 자궁경부세포검사를 통해 조기 발견이 가능하며, 조기 발견된 경우 비교적 간단한 수술적 치료로 완치 가능한 암입니다.

※ 성경험이 있는 20세 이상의 여성은 매 2년마다 자궁경부세포검사를 받으실 것을 권합니다.

※ 자궁경부세포검사 결과가 결과 이상소견이 없더라도 비정상 자궁경부출혈 등의 증상이 있는 경우 반드시 의사와 상담이 필요하고 검진결과 이상소견없음 이외의 판정을 받은 경우, 권고사항에 따라 조치를 취하시기 바랍니다.

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귀하의 자궁경부암 검진 결과를 위와 같이 통보합니다.

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요양기관기호 검진기관명

※ 암검진 결과통보서는 별첨의 암검진 결과 기록지를 근거로 검사항목에 따라 변형해 작성 210㎜×297㎜ [백상지 80g/㎡]

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