Forms

Select the form that you need:

Form	What this form does:
Chain of Custody Request	Order tests that could be used in a court of law.
Critical Values Notification	Define contacts for critical values notifications.
Maternal Screening Material	Obtain certification for maternal screening.
Patient Information and Signature Forms	Use these when a test requires additional information or signatures.
Add Tests to an Order	Request additional tests after a specimen has been shipped.
Test Setup Request	Generate a spreadsheet containing the setup information for multiple tests, and use the spreadsheet to build ordering codes and test (result) codes into your laboratory information system (LIS).
Downtime Forms	Download these forms in advance in case you ever need to order tests or supplies when Internet applications are unavailable.

Manual Test Request Forms

If you order tests manually by submitting printed forms, use the following forms for specific tests.

• Allergen Test Request (T236)
• Benign Hematology Test Request (T755)
• Biogen Program Alzheimer's Test Request (T888)
• Cardiovascular Test Request (T724)
• Children's Oncology Group Test Request (T829)
• Coagulation Test Request (T753)
• Gastroenterology and Hepatology Test Request(T728)
• Hematopathology/Cytogenetics Test Request (T726)
• Immunohistochemical (IHC)/In Situ Hybridization (ISH) Stains Request  (T763)
• Biochemical Genetics Test Request (T798)
• Iothalamate Test Request (T890)
• Microbiology Test Request (T244)
• Neurology Test Request (T732)
• Oncology Test Request (T729)
• Pathology Consultation Request (T246)
• Prostate Health Index (phi), Serum (T792)
• Renal Diagnostics Test Request (T830)
• Therapeutics Test Request (T831)

If none of those tests apply, use the General Test Request (T239)

After completing and printing, send the form with your specimens to Mayo Clinic Laboratories.