Vitalant Specialty Laboratories & Therapeutics


Test Requisition Form - Please complete all fields on the top of the form.

New Client Form

UPMC Children's Hospital Test Requisition Form (FOR USE BY UPMC CHP STAFF ONLY!)
NOTE: This form was revised on 2/21/13; the changes include: please circle either PRE/POST at the top of the form to indicate if a specimen was drawn before or after treatment; BOLD test names represent tests that need to reach the laboratory within 4 hours of draw time; we require 10cc citrated whole blood maintained at ambient (room temperature) for Adenine Nucleotides test.

Effective March 1, 2020, the maximum turn around times for our molecular assays will be updated to align with current laboratory practices.