MolecularMD offers personalized medical diagnostics for quantitation analysis of BCR-ABL.  All assays are performed by highly experienced technicians using the very highest quality reagents and equipment to ensure sensitive, reproducible results.

To place a service order with MolecularMD, download the requisition form, fill in the patient and billing information, and send the form along with your samples to our Portland testing facility:

MolecularMD
2611 SW 3rd Ave.
Portland, OR 97201

Prices:
To access our services, please contact MolecularMD Customer Service to receive a quote via phone 1-888-663-7382 or email customerservice@molecularmd.com.   

Sample Collection:
Please see the individual assay documents below for specific sample collection instructions.

  - BCR-ABL QUANTITATION SERVICES
  - BCR-ABL KINASE DOMAIN SEQUENCING SPEC SHEET
  - BCR-ABL T315I FRET SPEC SHEET

Shipping:
Please see the shipping guidelines document below for more detailed instructions. 
 - Shipping Guidelines

Shipping terms are FOB shipping point

• Place labeled EDTA specimen tube(s) in one zipper specimen bag with the absorbent and/or labeled PAXgene specimen tube(s) in another specimen bag with absorbent.
• Place the completed requisition form in the front or back pocket of the specimen bags.
• Place each specimen bag in a separate bubble wrap pouch.  You may need to fold the specimen bag around the tubes to fit it in the bubble wrap pouch.
• Place the bubble wrap pouch, including the specimen bags, inside the cardboard box and seal with packing tape.
• The outside of the box should be clearly labeled “Diagnostic Specimen” and “UN3373”.  Do not cover these labels.
• Complete the air waybill in full, including the sender’s and recipient’s complete names, addresses and phone numbers.
• If shipping at room temperature within the US, ship via overnight delivery service for Monday to Saturday delivery to:

MolecularMD
2611 SW 3rd Ave
Portland, OR 97201

Note:

• If shipping on a Friday, be sure to check the “Saturday Delivery” box on the air waybill to ensure next day Saturday delivery. 
• If shipping on dry ice, use additional shipping materials for dry ice packaging.  Shipment times longer than 24 hours are acceptable for frozen samples provided sufficient dry ice quantity/-20C package temperature is assured.

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Test Requisition:
Test requisition forms are available for download, please see the link below.  Manual test requisition forms are available through MolecularMD customer service.  Call 1-888-633-7382 and a customer service representative will assist you in obtaining a form. 

  - Download the Test Requisition Form

• Complete a separate test requisition form for each patient.
• Use a black or blue pen and write legibly.
• Fill in the information requested on the form.
• Mark boxes with an [x].
• Keep a copy for your records.
• Use a separate tube for each patient sample. 
• Call Customer Service to inform them that your samples have been shipped.

Test Requisition Requirements:
All test requisitions must include the following:
1.  Contact name and telephone number
2.  Physician name and UPIN
3.  Complete insurance information (if applicable)
4.  Quantity of samples and sample type
5.  Service desired
6.  Please include any special ordering information and/or questions.
7.  Note any special results delivery needs.
8.  Fax or email for results (if applicable)

Sample Receipt Confirmation:
Convenient email and fax confirmations are provided at the time your samples are received, if this is requested on the test requisition form.  Please provide information in the “Requests, Patient History or Comments” section of the requisition form.  Additionally, receipt of samples can be confirmed by calling Customer Service at 1-888-663-7382. 

Payment Terms:
Credit terms are net 30 days.

Remit payment to:
Accounts Receivable
Molecular MD
2611 SW 3rd Ave.
Portland, OR 97259

Receipt of damaged samples:
If the packaging or samples are damaged upon receipt, a customer service representative will contact you with further instructions. 

For additional ordering information, please contact Customer Service at
1-888-663-7382 or customerservice@molecularmd.com.