How to Request a Consult and Submit Samples
Complete the Pathology Consultation Requisition Form.
Please confirm all information is complete in this form to ensure the most quick and accurate results for your patients.
1. Select the pathologist to perform this consultation. Learn more about our team members and various subspecialties.
2. Complete the form with all required information - This information will ensure patient safety, identification, and accurate processing of consult cases. Demographic information is required to process specimens. Patient insurance information is required for third party billing. If self-pay, the case will be placed on hold until payment information is provided. Referring entity is responsible for obtaining pre-authorization from the payer if required. If the consultation request form is incomplete, the slides will not be reviewed. If payment is denied by the patient's insurance, the ordering institution/provider will be invoiced for the services and will be responsible for payment.
Required Sections
Client Billing
- Requesting provider/institution
- Specimen information
- Patient information
- Physician signature
Third Party Billing
- Requesting provider/institution
- Specimen information
- Patient information
- Billing insurance information
- ICD10 Codes
- Physician signature
3. Pathology report - Please include specimen source, collection date, and clinical history when available.
4. Specimen/Glass Slides - Please package slides and/or paraffin blocks to ensure the integrity of the specimen(s) during shipping, handling, and exposure to excessive temperatures. See more information on Shipping.
5. Return of pathology materials will be by US Postal Service unless a FedEx or UPS account number is provided at the time of submission.
For questions regarding submitting samples, please call Pathology Customer Care at 305-243-7284 or email pathology@miami.edu.
For billing questions, please contact pathologybilling@miami.edu or call 305-243-5838 or fax 305-243-1624.