Requisition Forms

Certain laboratory services and materials are unique to your geographic region. Please choose from the links listed under your state to access the forms listed.

Contact information for each region can be found here.


Alabama, Arizona, Colorado, Louisiana, Idaho, Minnesota, Mississippi, Montana, Nebraska, Nevada, New Mexico, North Dakota, South Dakota, Tennessee, Texas, Utah, Washington, Wyoming

Illinois, Ohio, Pennsylvania, West Virginia

New Jersey, New York

Billing Information

Reference Laboratory Coagulation testing, and Therapeutic Apheresis services along with cellular therapy processing services, are billed directly to our hospital customers once a month from the finance department of Vitalant in Phoenix, Arizona. Transfusion Services testing, HLA, CTL, IRL and blood components are invoiced to the customer semi-monthly. Payment terms are net 30 days, unless otherwise agreed.