DERMATOPATHOLOGY

University of Colorado Dermatopathology Consultants Physical Address: University of Colorado Dermatopathology Consultants 1665 N. Ursula Street ACP Building, 3rd Floor, Room 3247 Aurora, CO 80010 Mailing Address: University of Colorado Dermatopathology Consultants P.O. Box 6510 Mail Stop F703 Aurora, CO 80045-0510

Dermatoimmunologists James E. Fitzpatrick, M.D. Whitney A. High, M.D. Marti Friednash, M.D. Anwell Chang, M.D. Lori Prok, M.D. Contact Information Phone: 720-848-0535 Fax: 720-848-0591

Specimen Information - Page 2

Specimen B: Alopecia Protocol  Lesional / Perilesional Biopsy Electron Microscopy (EM)

Site / Slide Num:   CollectionDate:  CLINICAL FINDINGS

CLINICAL PHOTOS Enclosed with Specimen Sent Digitally ICD-9 Code(s) 1. 2.

Specimen C: Alopecia Protocol  Lesional / Perilesional Biopsy Electron Microscopy (EM)

Site / Slide Num:   CollectionDate:  CLINICAL FINDINGS

CLINICAL PHOTOS Enclosed with Specimen Sent Digitally ICD-9 Code(s) 1. 2.

Specimen D: Alopecia Protocol  Lesional / Perilesional Biopsy Electron Microscopy (EM)

Site / Slide Num:   CollectionDate:  CLINICAL FINDINGS

CLINICAL PHOTOS Enclosed with Specimen Sent Digitally ICD-9 Code(s) 1. 2.