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

e-Requisitions

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.

   A-1a Doctor-Provider Orders - Pathology Blood Center - Downtime Use Only

   A-1a Doctor-Provider Orders - Pathology Bone Marrow - Downtime Use Only

   A-1a Doctor/Provider Orders - Pathology Core and Specialty Care Nursery - Downtime Use Only

   A-1a Doctor-Provider Orders - Pathology Cytopathology - Downtime Use Only

   A-1a Doctor/Provider Orders - Pathology Immunopathology - Downtime Use Only

   A-1a Doctor-Provider Orders - Pathology Microbiology - Downtime Use Only

   A-1a Doctor/Provider Orders - Pathology Molecular - Downtime Use Only

   C-12 Cytogenetics Request - Downtime Use Only

   H-1 Surgical Pathology Consult - Downtime Use Only

   H-2 Pathology Consult - Derm - Downtime Use Only


e-Forms

   A-1a Doctor/Provider Orders - Post Fluid Exposure - Source Patient Eval - Downtime Use Only

   G-9 Blood Transfusion Record

   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