ACT Pathology Request form-editable

Somatic Mutation Testing Request form

Somatic Mutation Testing Request form

When ordering Somatic Mutation tests such as EGFR, KRAS, BRAF,etc please download and complete the Request form above.
Please send completed form to:
Fax: 02 6244 2892
Address: Attn: Kate Bareis,
Anatomical Pathology, ACT Pathology
PO Box 11 Woden ACT 2606
ph: 02 6244 2867

For advice regarding these tests, Dr Mitali Fadia (ph: 62442880),Prof Jane Dahlstrom (ph:62442658) or Mr Craig Kennedy (laboratory, ph: 62443705) may be contacted.

Post Mortem Forms

Adult Post Mortem Information

Permission for Post Mortem Examination Form

Child Babies Post Mortem Information

Other Forms

Billing of tests Non-refundable by Medicare