Please include a completed requisition with each patient sample referred to the Diagnostic Laboratories. You may print a blank requisition by selecting it below. Requisitions preprinted with your name, address and client number are available from Client Services.
Please note, if RNA or DNA samples are being sent, isolation of nucleic acids for clinical testing MUST occur in a CLIA-certified laboratory or a laboratory meeting equivalent requirements as determined by the CAP and/or the CMS. Additional specimen requirements can be found on the individual test requisitions or in our online test catalog
For IRL forms please visit the Immunohematology Reference Lab page.
To request Platelet Aggregation testing for your patient, complete this form. Testing available for Wisconsin-based clients only.
For additional information review the provider and patient information sheets.