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Requisitions & Billing Forms

 

Please complete the forms that are specific to the test(s) you are requesting. Work will not begin on samples that arrive without the completed paperwork.

Sequencing Forms--complete the following forms when requesting sequencing.

Cytogenetics Forms--use this form when ordering routine chromosome analysis and/or FISH studies.

Molecular Testing Form--use this form when ordering molecular services.

Cancer Requisition--use this form when ordering chromosome and/or FISH anaysis, CMA, or sequencing for cancer.

DNA Storage Form

Authorization to Release/Request an Individual's Health Information (Link to Form) This form should be completed by the patient or their designated advocate.

Our forms are in Adobe Acrobat PDF format. You can download Adobe free at the following link. http://www.adobe.com/products/acrobat/readstep2.html

 


Contact Information

Genetics Laboratory
University of Oklahoma Health Sciences Center
1122 NE 13 Street, Suite 1400, Oklahoma City, OK 73104
Phone: (405) 271-3589 |Fax: (405) 271-7117 After hours phone: (405) 496-9514

Email Contact: Dr. Shibo Li, Lab Director

 


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