Requisition slips
 
        
        
    All rights to the listed requisition slips are the exclusive property of Labor Berlin. Embedding on third-party homepages or otherwise making available for download in third-party offers is expressly prohibited without a separate written agreement with Labor Berlin.
Note for private individuals / private direct senders of samples without a medical referral form
We can only analyze and test sample material sent to us if we have a laboratory order from the doctor treating you (referral form for laboratory tests, sample 10 for those with statutory insurance/private referral form for those with private insurance).
Direct submissions from private individuals on a self-payer basis without a medical referral form must be coordinated with us in advance via meinlabor@laborberlin.com (see also mein.laborberlin.com). You will then receive a list of the estimated costs and a private medical treatment contract. We expressly reserve the right to refuse laboratory analyses if they are so specific that they should only be requested by a treating physician – also in order to ensure a medically meaningful diagnosis and a holistic interpretation of the laboratory findings.
We ask for your understanding that we will not process submissions from private individuals that have not been agreed with us in advance and that are made without a medical referral form.
Note for submitting institutions
Please note:
Services for private patients, self-paying patients or elective laboratory services will be invoiced by Labor Berlin directly to the respective payer, unless otherwise agreed with the sender.
For this purpose, the sender shall forward the necessary patient data to Labor Berlin and ensure that the patients are informed about the possible forwarding of laboratory orders to Labor Berlin and the associated organizational measures, including billing by a private medical clearing office, in the manner prescribed by law and consent to this.
The legal requirements with regard to the free choice of doctor are taken into account. We would like to point out that, in accordance with the provisions of the German Hospital Remuneration Act (KHEntgG), external elective laboratory services must be ordered by the sender on a case-by-case basis and specifically by the elective physicians concerned.
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                Conducting genetic laboratory tests without consent in medical emergenciespdf
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                List of material abbreviations on findingspdf
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                List of method abbreviations on findingspdf
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                Request deactivation of fax transmissionpdf
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                Application for additional claimspdf
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                Declaration of consent for material transferpdf
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                Notification of patient mix-up / sample mix-uppdf
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                Declaration of consent for the performance of genetic testspdf
 
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                Requisition slip for allergy diagnosticspdf
 
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                Requisition slip for autoimmune diagnosticspdf
 
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                Consent slip for liquid biopsypdf
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                Requisition Slip Hämatologie Zytologie (Standort CVK)pdf
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                Hematology requisition slip (CCM location)pdf
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                Declaration of consent for tumor cytogenetics and tumor geneticspdf
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                Requisition slip for hematology combination certificate Cytology & Molecular Genetics (CVK site)pdf
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                DPD diagnostics requisition slippdf
 
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                Lynch syndrome request formpdf
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                Requisition slip for liver and pancreaspdf
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                Requisition slips for muscular & neuromuscular diseasespdf
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                Requisition slips for hearing impairment/deafnesspdf
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                Preanalytics Molecular geneticspdf
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                Preanalytics tumor cytogeneticspdf
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                Requisition slip for prenatal cytogeneticspdf
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                Requisition slip for postnatal cytogeneticspdf
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                Requisition slip for tumor cytogeneticspdf
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                Requisition slip for cytogenetics from abortion materialpdf
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                Requisition slip for connective tissue diseasespdf
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                CFTR requisition slippdf
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                Requisition slip for endocrinological diseasespdf
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                Requisition slip for lipid metabolism disorderpdf
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                Requisition slip for cardiological diseasespdf
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                Requisition slip for bone and skeletal diseasespdf
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                Requisition slip for congenital myasthenic syndromespdf
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                Requisition slip for lymphoedemapdf
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                Nephrogenetics requisition slippdf
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                Noonan syndrome requisition slippdf
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                Requisition slip for pulmonary hypertensionpdf
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                Requisition slip Rett-like and Angelman syndromepdf
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                Requisition slip for platelet disorderspdf
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                Requisition slip for primary immunodeficienciespdf
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                Requisition slip for lung diseasespdf
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                Patient information on incidental findings in WESpdf
 
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                Accompanying certificate for connatal CMV diagnostics from dried blood (newborn screening card)pdf
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                Virology requisition slippdf
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                Requisition slip virology hantaviruses (consulting laboratory)pdf
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                Requisition slip virology novel coronaviruses (SARS-CoV-2)Please use this request form as a color printout, as this is relevant for machine reading. pdf
 
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