Versiti - Requisitions

Please include a completed requisition with each patient sample referred to the Diagnostic Laboratories. You may print a blank requisition by selecting it below. Requisitions preprinted with your name, address and client number are available from Client Services.

Please note, if RNA or DNA samples are being sent, isolation of nucleic acids for clinical testing MUST occur in a CLIA-certified laboratory or a laboratory meeting equivalent requirements as determined by the CAP and/or the CMS. Additional specimen requirements can be found on the individual test requisitions or in our online test catalog

Contact Information
  • 800-245-3117 x 6250
    Diagnostic Laboratories
    Diagnostic laboratory services including HLA testing, donor testing, immunohematology reference lab testing, hematology testing and more.
    Hematology Genetics Testing
    The Hematology Genetic Testing Lab provides specialized hematology genetics custom testing panels, single gene testing and more.
    Hematology Testing
    Versiti provides von Willebrand factor tests, aHUS diagnosis, hemophilia lab tests and other laboratory diagnosis of bleeding and clotting disorders.
    Resources and Forms
    Browse Versiti’s library of resources, including test requisitions and descriptions, blood donor information, educational materials, and more.