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Test Info Update Form

Complete the form below to submit a request to add a new test, change existing test information or request deletion of a test.

IL Test Directory Test Add/Update Request Form

Mayo Clinic Laboratories

Test Code TESTID Display Name

Additional Codes

Epic:

Quest:

Mayo:

Testing Algorithm

Specimen Required

Patient Preparation:

Specimen Type:

Collection Container/Type

Preferred:

Acceptable:

Submission Container/Tube:

Specimen Volume:

Collection Instructions:

Additional Information:

Specimen Minimum Volume

Specimen Stability

Room temperature:

Refrigerated:

Frozen:

Reference Range

Rejection Due To

Rejection due to

Day(s) and Time(s) Performed

Days and times performed

Report Available

Clinical Significance

Clinical significance

Method Name

Method name

CPT Code(s)

CPT code

Performing Laboratory

Includes

Limitations

Aliases

Lab Processing Instructions (Lab Use Only)

Insert any processing instructions for the main lab staff to perform.

Make all text italics.

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