Thrombotic Microangiopathy
Test Requisition

Test Requisition

The laboratories at Cincinnati Children’s perform a variety of genetic, biochemical and functional assays for atypical hemolytic uremic syndrome and thrombotic thrombocytopenic purpura (both familial and acquired forms). 

Physicians do not need to 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. 

> Download the TMA test requisition (includes instructions for sample collection and shipping)

International Specimens


International samples sent for genetic testing require 10 mcg of extracted DNA shipped at room temperature to the address on the test requisition. Samples for biochemical and functional testing require adequate sample shipped frozen on dry ice.  Please email the courier’s name and tracking number to once the sample is sent.


All international samples must be prepaid by wire transfer, credit card or cashier’s check (made payable to Cincinnati Children’s Hospital Medical Center) enclosed with the sample.

Customs Forms 

Physicians from outside the United States who are requesting tests must complete a customs declarations form to accompany their samples.