To request an Anatomic Pathology Consultation, please complete the Anatomic Pathology Consult Requisition form in its entirety.
This form MUST BE SIGNED by the ordering provider and MUST INCLUDE the following:
- First and last name of ordering provider
- Complete name of the office/facility including address, phone number, and fax number
- Billing directives: will the provider’s office receive the bill or will the patient’s insurance company
- If the patient’s insurance company is to be billed, include updated demographic information as well as the contact information for the insurance company
- Indicate "Specimen Forwarded" and "Services Requested".
- For a list of special and immunohistochemical stains, in-situ hybridization and immunofluorescence options, refer to our stain menu. Our menu is frequently updated. If you have another request, please call Client Services at (800) 934-6575 for availability.
Questions? Contact the Nationwide Children's Hospital Anatomic Pathology Department at (614) 722-5450.
For information on our solid tumor and hematologic cancer fusion analyses (ARCHER panels), please visit our Laboratory Guide to Services for shipping instructions and request form.