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Diagnostic Center for Heritable Immunodeficiencies

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Test Requisitions and Customs Declarations Forms for Physicians

Ordering Tests | Customs Forms

The Diagnostic Center for Heritable Immunodeficiencies at Cincinnati Children's Hospital Medical Center performs a variety of molecular diagnostic and carrier tests for inherited immunodeficiencies and familial hemophagocytic lymphohistiocytosis.The Diagnostic Center for Heritable Immunodeficiencies at Cincinnati Children's Hospital Medical Center performs a variety of genetic and and cellular immunology tests for inherited immunodeficiencies and hemophagocytic disorders.  Doctors need not be affiliated with Cincinnati Children's to order tests.

Physicians Ordering Tests

When ordering tests, physicians must complete and sign the test requisition and enclose it with the sample. All information must be completed before the sample can be processed.

You can download the following test requisitions in portable document format (.pdf):

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Customs Forms

Download the free Adobe Acrobat Reader.Physicians from outside the United States who are requesting tests must complete a customs declarations form to accompany their samples. You can view a sample of how to complete the customs declarations form. (1.4 MB)

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Contact the Diagnostic Center for Heritable Immunodeficiencies