Pathology request forms

Download Pathology Queensland's general-use order forms by clicking the relevant link below.

Ordering specialised testing

If you need to order specialised testing, contact Central Core Laboratory Admin on +61 7 3646 5811 to arrange order forms and confirm processes.

Pathology Order forms List of pathology order forms
FormUsed for

Cervical screening request form (PDF 392 kB)

By clinicians to request cervical screening.

Private patient pathology request form (PDF 318 kB)

Used by public/private hospitals to order pathology tests for private Medicare eligible patients only where ieMR is not available.

Private patient pathology dried bloodspot CMV addon request form (PDF 345 kB)

Used by public/private hospitals to request newborn screening where ieMR is not used for private patients - includes cytomegalovirus add on.

Public patient pathology request form (PDF 319 kB)Used by public hospitals to order pathology tests on public patients where ieMR is not available.
Public patient pathology dried bloodspot CMV addon request form (PDF 344 kB)Used by public hospitals to request newborn screening where ieMR is not used - includes cytomegalovirus add on.
qNPM1 request form - additional information  (PDF 385 kB)Used by public hospitals to order qNPM1 MRD testing. Refer to form for additional information.
Rural and remote patient pathology request form (PDF 1078 kB)Used by clinicians in rural and remote areas to order publicly funded pathology tests for medically eligible patients.

Last updated: 3 August 2026