Online Requisition Form

(Detailed online form instructions)

1. Mandatory fields are marked with an asterisk *

2. Fill form with doctor’s, patient’s, and specimen information.  Put as much info on the online form as you desire.  Put the rest on the mail-in form.  No need to put in both form except for the required fields.

3.  Submit button will be at the bottom of the form.

4. Send your biopsy specimen in the pre-paid mailer.

5.  On the Mail-In form write “Online Submission” – no need to fill out information already filled out online.

6.  Mail-in form must include the doctor’s and patient’s consent signature.

Desktop Icon to Online Form Instructions (Windows):

1) Open the above online requisition form.

2) Copy the url: highlight the url -> CNTL-C

3) Right-Click empty space on your desktop

4) Select “New” and then “Shortcut”

5) Paste the above url:  CNTL-V, then “Next”

6) Name the Shortcut: example “SOPS OPR”

7) You now have an shortcut icon directly to the online SOPS Webform.

Download Paper Requisition Form

For Pre-filled forms with your office info, please call us. Scripps Oral Pathology Service Phone Number 858-784-0600

Download Adobe Acrobat Reader