PDF iconMORL Hearing Loss Test Requisition Form

OtoSCOPE v8.1 is now available.

How to order OtoSCOPE Testing:

  • Fill out the MORL Hearing Loss Test Requisition Form completely, including all of the clinical information requested on page 2;
  • Provide a pedigree, audiograms, clinic notes regarding hearing loss and temporal bone imaging studies (if performed);
  • Draw 8-10 cc EDTA whole blood OR provide 10 μg DNA, minimum concentration: 50 ng/μl (A260/A280 1.8-2) resuspended in 0.1mM EDTA (10mM Tris HC1, 0.1mM EDTA, pH 8, Teknova Cat#T0220).;
  • Ship whole blood at room temperature overnight Monday - Thursday to MORL;
  • Samples can be received Monday - Friday - do NOT ship on weekends;
  • The MORL will NOT submit to insurance, we can accept institutional billing or payment from the family by Visa or Mastercard.

Please contact us for more details at morl@uiowa.edu.