Client Services Requistion Forms

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Instructions: 

- You may fill out and fax either the PDF or the Online Version of the Requistion Form.
- The PDF Version must be printed out, then handwritten.
- You may type into the Online Version and then print it out.
- When printing the Online form, make sure the Print Margins are set to .25" or less
- After completing the Requisition Form, please review and fax it to: 720-848-0591

Dermatopathology PDF Requisition Form: Click Here to Download the PDF Dermatopathology Requisition Form

Dermatopathology Online Requisition Form: Click Here to Open the Online Dermatopathology Requisition Form

Immunofluorescence PDF Requisition Form: Click Here to Download the PDF IF Requisition Form

Immunofluorescence Online Requisition Form: Click Here to Open the Online IF Requisition Form



Client Services Supply Request Form

University of Colorado Dermatopathology Consultants
Client Services Submittal Form - Enter Your Information and Click Submit to Order Supplies
Start by entering your office information, then choose the supplies which you will need.
Practice Name:
Contact Name:
Street Address: Suite Number:
City: State: Zip:
Phone Number:
Email:
The following supplies are provided at no cost. Enter the quantity desired in the boxes below. For any item which you do not need, leave the corresponding box blank.
DescriptionEnter QuantityType
Formalin jars   box(es)
Michel's Media (for direct IF)   bottle(s)
Electron Microscopy Specimen Bottles (25% Gluteraldehyde)   bottle(s)
Padded Mailing Envelopes (25 Per Box)   box(es)
Biohazard Bags (100 Bags Per Bundle)   bundle(s)
Red-Top Tube and Packaging (for indirect IF)   tube(s)