Collection Brochures & Forms - Des Moines Laboratory

To make the collection and testing process as easy as possible for our clients, we provide the following brochures and forms for use. For printed copies, please contact MercyOne Laboratory Client Services at (515) 247-4439. 

Brochures

• Allergy Testing Brochure
• Patient Service Center Brochure
• 24-Hour Urine Collection
• Fecal Occult Blood Collection
• Glucose Tolerance
• Semen Analysis
• Sputum Collection
• Stool Collection
• Urine Collection
• Cytology Sample Collection Instruction
• Microbiology Sample Collection Instruction

Forms

• Supply Order Form
• Lead Testing Demographic Form
• Medicare ABN Form
• Medicaid ABN Form
• Tri-Care Waiver
• Wellmark Waiver
• Waiver of Non-Covered Services
• Tissue Log
• Iowa Maternal Screen Test Request Form
• Recommendations for Viral Testing of Upper Respiratory Illness

Histology Specimen Collection and Transport

MercyOne Laboratory provides containers to our clients for the transport of surgical specimens to the lab. 

The containers available to clients include:

• Screw-top containers containing formalin – 20, 40, 60, and 120 ml.
• Empty clear plastic containers with lids.  64 and 128 oz.

Label containers with patient information and make sure that screw caps are securely closed and the white lids are securely attached to the containers.

Store at room temperature and transport to lab within 72 hours.