Clinical Hematopathology Laboratory Submission Form
Please be sure to fill out the submission form on both pages completely. A hard copy must accompany the submitted sample. Please be sure to provide a history and clinical information so that we can offer the most useful interpretation of your results.
The form can be completed electronically and printed. The form can also be filled in with your clinic information, and saved as a fillable PDF on your local drive for use with future patients.
Contact us with any questions.