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8) 265-7240 PATIENT INFORMATION: STUDIES REQUESTED: Name: Histochemical/Enzyme Studies: Address: (completed on all muscle biopsies) Electron Microscopy Studies: select one Date of Birth: Male: Female: If Needed: Date of Biopsy: Definitely Yes: Time of Biopsy: Definitely No: Tissue Source:.

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Transport of specimens All specimen pots should be tightly sealed and transported using specimen bags, where appropriate. The request card should be placed in the pocket of the specimen bag, and the pot inside the sealed bag to ensure the safety of all staff.

How to Send a Biopsy Put tissue in formalin bottles, label bottles with the provided labels and place them in a biohazard bag. Include our completed biopsy order form in the bag with the bottle.

Tissue samples — also called biopsy specimens — usually come from one of the organs or organ systems listed below and help us diagnose common diseases.

Place tissue in leak-proof container with at least 30 mL 10% neutral buffered formalin. Wrap the container with Parafilm to prevent leakage. Double bag the specimen container with the requisition outside the plastic bag. Label the specimen with "Formaldehyde precaution" sticker.

The container is labeled with the patient's name and other identifying information (hospital number and birth date, for example) and the site of biopsy (exactly where on the body it was taken from). It's then sent to the pathology lab.

The biopsy specimen is placed in a sterile test tube containing sterile physiologic saline as the transport media (formalin is not used).

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Biopsy Request Form
This form is available in several versions.
Select the version you need from the drop-down list below.
2015 University Of Wisconsin Hospitals And Clinics Muscle & Nerve Biopsy Analysis Request Form
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  • 2015 University Of Wisconsin Hospitals And Clinics Muscle & Nerve Biopsy Analysis Request Form
  • Biopsy Request Form
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