New account form

If you are a new client interested in lab testing services, please complete and submit our online Lab IS Client Registration Form.

A paper version is also available.  

Requisition forms

Core Lab-Hematology

• Hematology Requisition Form

Core Lab-Coagulation

• Coagulation Requisition Form

Division of Anatomic Pathology

• Acetylcholinesterase Enzyme Requisition
• Anti-Enterocyte Antibody Requisition
• Anti-Enterocyte Antibody Clinical Form*
  • (*must be completed for each patient)
• Anti-Enterocyte Handling Instructions
• Consult Surgical Requisition
• Immunohistochemistry Requisition Form
• Consultation Autopsy Request Packet

Division of Genomic Diagnostics

• Cancer Test Request Form
• Genomic Diagnostic Requisition Form
• All Requisition, Clinical Information and Consent Forms

Hematopathology

• Oncology Bone Marrow Aspirate Submission Form (Outreach Clients Only)
• Oncology Bone Marrow Aspirate Submission Form (CHOP Patients Only)

Immunogenetics

• Immunogenetics Requisition Form

Immunology

• Immunology Requisition Form

Infectious Disease Diagnostics Laboratory (IDDL)

• IDDL Requisition Form
• COVID-19 Client Test Requisition Form

Metabolic and Advanced Diagnostics

• Metabolic Laboratory Requisition
• Specimen Requirements