Sample Forms

Choose a link below and fill out details for your sample analysis. Then submit your samples to our laboratory in person or by mail to the address at the bottom of the page.
Please include a list of sample IDs with your samples

Links to Sample Request Forms

The sample submission forms may be downloaded below. Please save the PDF and email us the completed form

The form cannot be saved if you complete it using Adobe Reader. However, it can be saved using Adobe Acrobat or the free Foxit PDF reader. If you choose to use Adobe Reader or another program that does not allow the file to be saved, you can print the completed form as a PDF.

Please include a list of sample IDs when you submit your samples.

To submit a sample request form as a member of the public, please use the link below:
Public Sample Request

To submit a sample request form from an academic institution other than OHSU, please use the link below:
Academic (Non-OHSU) Sample Request

To submit a sample request form from OHSU, please use the link below:
OHSU Sample Request

Submitting Samples

Samples may be mailed to the address below. If you would like to drop them off in person, please see Contact Us for useful information on locating and visiting our laboratory.

Dr. Martina Ralle 

Department of Molecular and Medical Genetics

Oregon Health & Science University

3181 SW. Sam Jackson Park Rd L103

Portland, OR

97239

Sample Tubes and Notebook