Test Requisition Forms:
Choose from the items below to select the appropriate Test Request Form. If you are a new Laboratory client, please contact us for additional information & assistance (678-225-0222, extension 109).

• Next Generation Sequencing test requisition form (PDF)
• Neurochemistry Test Requisition (PDF)
• Molecular Test Requisition (PDF)
• Mitochondrial Disease Test Requisition (PDF)
• Histology/Immunohistochemistry Test Requisition (PDF)
• Tissue Culture Test Requisition (PDF)
• Nerve Biopsy Test Requisition (PDF)
• Add-on Test Request Form (PDF)

Specimen Requirements/Collection Protocols/Shipping Information:

• Next Generation Sequencing Testing Guide
• Specimen Collection and Processing Requirements (PDF)
• Collection, Processing and Transport of FRESH Muscle Biopsy (PDF)
• Collection, Processing and Transport of FROZEN Muscle Biopsy (PDF)
• Neurochemistry Collection Protocols (PDF)

Consent/Privacy Documentation:

• Patient Consent Form (PC01) (PDF)
• Informed Consent Form for DNA Testing (PDF)
• HIPAA Information Form (HP01) (PDF)
• NY Informed Consent for Genetic Testing (PDF)
• Specimen Release Form (PDF)
• Sample Donation Form (SD01) (PDF)

Billing Forms & Information:

• Insurance & Billing Demographics Form
• Institutional Billing Payment Options Form
• Patient Payment Options Form
• 2013 Pricing & CPT Code List (PDF)

Online payments:
Avoid mailing your payment, use our secure online credit card processor at:
Secure Online Payment. Please do not use this feature if your scheduler informed you to make a deposit to secure an appointment. Send in our payment form or a check to secure an appointment.