Requisition forms for submitting clinical pathology testing, cytopathology or anatomic pathology are provided. In addition, custom requisitions are available by contacting client services or your account representative at 317.491.6000 or 1.800.433.0740. For submission of samples for consultative services, please use the appropriate special form located in the Anatomic Pathology section.
Requisitions are for either client/facility billing or for billing to the patient/insurance company. Please print the type of requisition needed and use the one appropriate for the requested billing type. The highlighted fields at the top of the requisition indicate required information and must be filled out.
Jump ahead on this page