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Cytogenetics Forms

 

Please include a completed requisition form, and billing information form with specimens sent for cytogenetics. Work will not begin on samples that arrive without the completed paperwork.

Cytogenetics Requisition Form--use this form when ordering routine chromosome analysis and FISH studies on peripheral blood, amniotic fluid, CVS, POC, and buccal swab.

ABN Waiver--required for Medicare patients, refer to Medicare approved diagnosis list.

Tricare Waiver--Please click on the link and read the information provided.

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 Email: Dr. Shibo Li

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