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washington.edu/oralpath INSTRUCTIONS ON COMPLETING THIS FORM To ensure swift processing of your patient s biopsy: 1. Please staple all attachments such as copies of insurance cards to the four pages of this lab request form. This page should be the cover sheet. 2. Please fill out all fields on these forms. Write N/A in place of blank fields. Please fold this four-page document and insert it into the box that will be sent to our lab. This form MUST accompany the biopsy bottle. Please.

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