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Labcorp pathology requisition form

Download the ETR Requisition Form V1 - Department of Pathology 2026

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The document is a Research Histology and Bio-Repository Services Request Form from the UCI Department of Pathology, detailing the information required for requesting histology services and human tissue specimens. It includes sections for user information, compliance details regarding the use of human and animal tissues, service requests with associated costs, and authorization signatures. The form outlines various histology services available, including specimen processing, staining options, and immunostaining antibodies.

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Click ‘Get Form’ to open it in the editor.
Begin by filling in the 'User Information' section. Ensure all fields are completed, including today's date, principal investigator's name, and contact details.
Proceed to the 'Compliance Information' section. Indicate whether your requested services involve human or vertebrate animal tissue and attach any necessary approval letters.
In the 'Pathology Core Services Requested' section, specify the histology services you require by entering quantities and costs as applicable.
Complete the required authorization signatures at the bottom of the form to certify that all information is accurate.
Review your entries for accuracy before saving or submitting your completed form through our platform.

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