Supply Orders

SUPPLY REQUEST FORM

Lower Columbia Pathologists is pleased to offer collection supplies at no charge for testing to be performed at our laboratory. Please fill out the form below and your supplies will be delivered within 48 hours. If you need your supplies STAT, please indicate that below.

An asterix (*) indicates a required field

Date (mm/dd/yy)*

Clinic*

Email*

Completed By*

STAT Deivery

Sure Path kits (Vials and Brooms)

Sure Path Brushes

Sure Path Cervix Brush Combi

Cardboards

Pap Pack Kits (Conventional)

Cytorich Red

Urine/Sputum/FNA Containers (with fixative)

Urine/Sputum/FNA Containers (without fixative)

Cytology Pump Spray Fixative

Slides (Frosted End)

GYN Cytology English

GYN Cytology Spanish

Blank Form

Blank Spanish Form

Biohazard Bags

20ml Fixative Bottles

60ml Fixative Bottles

120ml Fixative Bottles

Cervical Biopsy Kit

Dermatology Kit

Urology Kit

Patient Billing Information Cards

LCP Requisitions

Supply Request Form

Nuclear Medicine Map

Spanish Negative Pap Notices

English Negative Pap Notices

Special Requests:

Antispam Question*

Please answer the following simple question:
What is the last letter of the alphabet?

LCPath

Supply Orders