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Biopsy Submission Guidelines
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Supply Order Form
Quantity Wanted
Combi Brush
Blue Handle
50/bag
Cervex Brush (Broom)
Blue Handle
25/bag
EndoCervex Brush
Blue Handle
50/bag
Snap Off C-E Brush (Cytobrush)
White Handle
50/bag
SurePath Sample Collection Kit
Pap Perfect Clear Plastic Spatula
+ Cytobrush Plus Detachable Brush
25/bag
SurePath Specimen Vial
Liquid Based Pap Smear
25/flat
Pap Pak
Conventional Pap Smear kits
25/box
1 oz. 10% Formalin Biopsy Bottles
24/box
3 oz. 10% Formalin Biopsy Bottles
24/box
Small Biohazard Specimen Bags
100/box
Requisitions:
Miscellaneous:
Date Requested
* Clinician
* Location
Attention to
* Email Address
* - Indicates required field
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Copyright © 2005 Diverse Network Associates Inc. and its licensors. All rights reserved.
