e-Requisitions and Forms
UIHC Pathology Laboratories

e-Requisitions

   0-9 Bone Marrow Laboratory Consult Form

   A-1a Clinical Microbiology Laboratory Requisition

   A-1a Doctor's Order - Blood Center Request

   A-1a Doctor's Order - Critical Care/Special Care Nurseries Laboratory Order

   A-1a Doctor's Order - Immunopathology Laboratory

   A-1a Doctor's Order - Inpatient Service

   A-1a Doctor's Order Laboratory Test

   A-1a Doctor's Order - Miscellaneous Request

   A-1a Doctor's Order - Molecular/Diagnostics Laboratory

   A-1a Doctor's Order - Therapeutic Drug Assay

   C-12 Cytogenetics Request

   E-1 UIHC Consultation Form

   Epic Downtime Requisition

   H-1 Surgical Pathology Requisition

   H-1a Dermatopathology Consultation Request

   H-2 Cytologic Consultation Request


e-Forms

   A-1a Laboratory Order for Post-Exposure - Evaluation of Source Patient

   G-2d16 Consent to Human Immunodeficiency Virus (HIV)-Related Testing
   The consent form is a multi-part form which should be ordered from Hospital Stores (#923747).
   The scanned document above is for your reference only.