e-Requisitions and Forms
University of Iowa Hospitals and Clinics Pathology Laboratories


NOTE: The UIHC Department of Pathology uses Epic as the Electronic Medical Record (EMR) for all laboratory tests for orders on UIHC patients. The e-requisitions below are provided for disaster/downtime circumstances only when the Epic EMR is down. Alternatively, Pathology Outreach uses Test Requisitions or specific clients use our Atlas web portal for lab and pathology orders.

   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


   A-1a Laboratory Order for Post-Blood/Body Fluid Exposure - Source Patient Evaluation

   G-2d2 Consent for Blood Transfusions

   G-2d16 Consent for Human Immunodeficiency Virus (HIV)-Related Testing Due to a Healthcare Worker Exposure
   to Body Fluids to be used for Minors (<18 Years of Age)

   G-2d16 Consent for Human Immunodeficiency Virus (HIV)-Related Testing to be used for Minors (<18 Years of Age)

   HIV Pre-test Education