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COVID-19: Vaccine information, visitor restrictions, and additional resources | Medicaid: The program is changing and you must take steps to keep your UNC Health providers

Forms & Requisitions

Use the information below to obtain forms or requisitions for Clinical Laboratories, Anatomic Pathology, or IRB/Research.

Clinical Laboratories

Add-on Laboratory Test Request "Specimen in Lab" - To be used only when unable to place a computerized add-on order directly in the Hospital SMS ordering system. Add-ons for Transfusion Medicine Services must be ordered through CPOE or a Blood Component Order Form.
Allergy Requisition: In-House Testing
Direct Phlebotomy Requisition - To be used only for patients having phlebotomy performed at McLendon Clinical Laboratories Outpatient Phlebotomy Services.
Histocompatibility Laboratory Requisition (Tissue Typing Lab)
Histocompatibility Laboratory Requisition (Dialysis and Mailers)
HLA Alleles with Identical Antigen Bind Domains - Follow the link and download the excel file for the latest release.
Human Milk Exposure
Karyotype Request Form: In-House Request
Karyotype Request Form: Outside Referral Request
Maternal Serum Positive Result Form
Maternal Serum Screen Request Form
Maternal Serum Screen Recalculation/Data Change Request Form
Molecular Genetics Test Request
Molecular Genetics Testing - Directions for Drawing and Mailing Blood Specimens
Outpatient Laboratory Requisition (Outreach Services)
Patient Registration Form
Post-Exposure Source Patient Testing Requisition
Therapeutic Phlebotomy Order Form

Anatomic Pathology

IRB/Research Forms