Forms & Requisitions

Submit Specimens

Existing clients

Are you an existing client of Inform Diagnostics? Please print and complete the applicable form linked below and fax to (866) 688-3280. Be sure to contact Client Services to request a supply of customized requisitions.

If this is your first time ordering from Inform Diagnostics, please contact our Client Services team to establish your client profile. We’ll be happy to answer your questions.

Breast Pathology

Breast Pathology Requisition

Breast Approved Protocols Form – FO Hereditary Cancer Panel      

Dermatopathology

Dermatopathology Requisition

Dermatopathology Approved Protocol Selections

Podiatric Pathology Requisition

Gastroenterology & General Surgical Pathology

GI Pathology Requisition

GI Approved Protocols Form

GI Approved Protocols Form – FO Hereditary Cancer Panel

Suggestions for Collecting GI Specimens: Help Us Help You

General Surgical Pathology Requisition

Hematology/Oncology

For hematology/oncology requisition 

forms, please visit us at Fulgent Oncology. 

Urologic Pathology

Urologic Pathology Requisition

Prostate Fusion Biopsy Requisition

Urologic Pathology Approved Protocol Selections Form

Additional Resources

Client Resource Guide

Additional Forms

Discrepancy Resolution Form

One-Time Authorization of PHI Release Form

Pathology Consultation Requisition

Additional Test Requisition

Test Cancelation Requisition

Specimen Log Form

Record of Loan Form Coppell

Record of Loan Form Boston

Record of Loan Form Phoenix

Help for Clinicians

Need instructions and answers?

Download our Client Resource Guide.

First-Time Clients

Getting started with Inform Diagnostics

If this is your first time ordering from Inform Diagnostics, please contact our Client Services team to set up your client profile.

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