Requisition Forms


ATTENTION:

Before downloading and using these requisition files, please call our Client Services Department at the phone number below to request to have paper copies of the appropriate requisition type shipped (via FedEx) to your practice. At this time, we prefer for our clients to send us specimen information on our pre-printed requisitions.

If you cannot wait for pre-printed requisitions to be shipped to you, please ensure that you complete the required practice identification information at the top-right corner of the requisition before submitting it along with your patient's specimen for testing at UF Health Pathology Laboratories. Failing to do so will alter the expected turnaround time for your test results.

Call our Client Services Department at 352.265.9900 if you have any questions on this procedure. 

 

General Pathology Form
(covers breast, cytopathology, ENT, eye, GI & hepatopathology, urologic, pulmonary, renal and surgical)

  • Anatomic Pathology/Non-GYN Cytology Form
    (includes tests for breast carcinoma markers, gastric/gastroesophageal carcinoma, colorectal carcinoma, lung carcinoma, melanoma/thyroid, gestational trophoblastic disease/molar pregnancy evaluation and UroVysion/urine FISH)
Renal/Muscle/Nerve Pathology
Consultation Form
Cytogenetics Forms
Clinical/Molecular Pathology and Endocrinology Form
Oral and Maxillofacial Pathology
Clinical Toxicology
  • Clincal Toxicology Requisition
    (includes comprehensive/benzodiazepine/opioid/ethanol biomarker panels; assays for amphetamines, barbiturates, cannabinoids, cocaine, heroin, muscle relaxants and hallucinogens; drug class screen; and specimen validity)
Urologic Pathology

 

 

 

 

 

 

 

 

 

 

 

Gastrointestinal & Liver Pathology
Gynecological Pathology
Hematopathology and Cytogenetics
Podiatric Pathology
Dermatopathology
Immunohistochemistry
and Special Stains

 


 

 

 

 

 

 

For Physicians