Forms & Supplies

Documentation is extremely important to quality patient care. Providing specific patient specific case information will insure that specimens are handled appropriately and in a timely manner. Should you not find or need assistance in locating the appropriate form to utilize, please contact our LSU Health Shreveport Pathology Outreach Services Personnel for assistance:

Patient Client Services: 318.675.8475
Pathology Central Receiving: 888.252.3902

Test Request Forms

  • Anatomic Pathology Consultation Request
  • Clinical Pathology Testing Request
  • Cytogenetics Testing Request
  • Cytology – Fine Needle Aspiration Smear Review Request
  • Cytology – GYN Pap Smear (Image Guided, ThinPrep, or Conventional) Request
  • Cytology – HPV Reflex on Pap Smear Request
  • Cytology – Non-Gyn Brushing and Smears Review Request
  • Cytology – Non-Gyn Fluid Review Request
  • Flow Cytometry Testing Request
  • Virology Test Request
  • Electron Microscopy Request
  • Histology and Special Stains Request
  • Immunohistochemistry Request – Outreach Only
  • Immunohistochemistry Request – In-house Only
  • Molecular Pathology Testing Request*
  • Muscle Testing Request – In-house Patients Only
  • Muscle Biopsy Testing Request – All Other Patients
  • Nerve Testing Request
  • Off-site Visit Documentation/strong>
  • Renal Consultation Test Request
  • Surgical Specimen Review Request
* Used to request this testing. Please complete entire form. Should Cytogenetics and/or Molecular Pathology and/or Flow Cytometry testing be required on the same specimen, only one form need be completed.

Additional patient information can be faxed to the following secure fax line.
Fax: 318.675.4568