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Instructions
1. Download The Test Requisition
Test Requisition Form Download Link
You will need the free Adobe
Reader to read the Test
Requisition Form - A new
version is coming soon.
Required Information: Name, Address, DOB, SS#, Insurance Information, Physician Information.
Contact Veripath OncoDiagnostics for information on specific tests to be ordered.
Send Completed Form to:
Veripath OncoDiagnostics
2110 Research Row
Dallas, TX 75235
Phone: (214) 645-7053
Fax: (214) 645-7020
2. Complete Consent Form and send to Releasing Laboratory
Request Releasing Laboratory to send representative tumor block & correspending pathology report to:
Veripath OncoDiagnostics
2110 Research Row
Dallas, TX 75235
Phone: (214) 645-7053
Fax: (214) 645-7020
3. Please e-mail to Veripath OncoDiagnostics that your test(s) has been requested. You will receive confirmation. | 
