Requisitions

Please include the following when submitting a tissue specimen: a requisition form including clinical information and morphology / DDX, the patient's demographics (name, DOB, address, & insurance information), as well as any prior pathology reports if applicable.

​

​

Upon completing this fillable special stain request form, please include it in your next courier pick-up batch or fax directly to (503) 245-8219.

​

​

​

​

​

​

Please submit nail clippings or shavings in the provided plastic bag or empty specimen bottle. Please write patient identifiers on the bag or bottle as well as on the requisition form. In addition to the clinical information, please include patient demographics and insurance.

​

​

These forms are provided as a supplemental visual description of the affected nail area. When submitting a nail or nail bed matrix specimen, attach this form with the requisition form.

​

​

​

​