Penn Medicine

Personalized Diagnostics Intake Documents Download

For Physicians outside of Penn Medicine:

Physicians outside Penn Medicine who are interested in the services of the CPD can contact the Laboratory directly at 215-573-0675.

Visit the Contact section for more information.

For Penn Medicine Physicians:

Outpatient requests are available in EPIC as a special studies request on an AP Consult orderable. After placing the order, a copy of the requisition documents below must be printed and faxed to either 215-614-1988 or 215-898-9817.

When sending specimens to the CPD, all inpatient test orders require completion of the following forms:

    Test Requisition Form
  • Test Requisition Form: Include patient, sample and reporting information; as well as selection of a sequencing panel.

  • Specimen Transport Guidelines
  • Specimen Transport Guidelines: Consult for all specimen requirements. Visit the For Physicians section for further details on testing and transportation conditions.

  • Billing Form
  • Billing Information Form: Include patient payment, insurance and institutional billing information.

For all requests, a qualified Pathologist will review the submitted or available material to ensure there is adequate tumor present.

Appropriate and adequate samples will then be processed by the CPD for DNA extraction and NGS testing, with results to be returned within 14-21 days (visit the Services section for further information on genetic sequencing reports).

Please download and complete the intake documents below, then send with both blood and bone marrow specimens. Or, fax a copy of the requisition to 215-614-1988 (or 215-898-9817 for all other requests).

Questions & Information:

Call 800-PENN-LAB