LLSG Request for Service Pathology

Request for Services - Pathology

We welcome the opportunity to serve you. Please provide us with the details of your service request, and we will contact you with a quote and directions for specimen handling should you be ready to proceed. Should you prefer to discuss your service needs, please contact us directly at 1-519-685-8500 x56495, or lab@lhsc.on.ca.

If you require human tissue for research purposes from LHSC/St. Joseph's please go to Tissue & Archives.

Financial Quote Only
Financial Quote and Proceed with Service
Clinical
Research
Requesting Hospital/Physician/Researcher:Contact Name:
Email Address:Address:
Billing Address
(If different from above):
Phone Number:
Existing Contract with PaLM:Research Cric Number or LHR number:
(if no Grant No. given, researcher will be billed directly):
Yes   No
Service Request:
Specimen Description:
Species:
Testing Required:
List all testing required for each specimen
Special Handling Required:
Comments/Special Requests:
Quantity of Specimens:
Testing Frequency:
One-Time
Daily
Weekly
Bi-Weekly
Monthly
Yearly
As required
If other than one time, approximate number of tests per frequency:
Consultation Required:
Yes
No
Turn Around Time Required:


I have read and agree with the Standard Terms and Conditions: Please make a selection.


Schulich School of Medicine and Dentistry London Health Sciences CentreSt. Joseph's Health Care LondonWestern University