All specimens sent to the Center must accompany a completed Test Request Form. For autopsy cases, the Autopsy Consent and Testing and Reporting Policies Forms must be completed and submitted to the Center along with the clinical history/medical records of the patient. Delays in reporting may result without this information.
The forms available on this page are in Adobe PDF format. You may download the free Adobe Acrobat Reader to view these files by clicking on the link below. If you have any questions, please contact us at 216-368-0587 or by email at email@example.com.
The Center is fully compliant with HIPAA regulations.
Test Request Form *NEW*
The new Test Requisition and Billing Form can now be completed digitally and must be included with all the samples submitted to the Center. For proper alignment of fillable fields, we recommend downloading the PDF and opening it in a PDF viewer on your device.