Men's Health Center at UWMC-Roosevelt

Male Fertility Lab: Referral Providers

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Healthcare providers can refer patients to Male Fertility Lab (MFL) clinical services. Referrals can be sent via fax using the requisition form or directly online using the UW Medicine Web form. Patients who are requesting appointments or self-referrals may call 206-598-6358

1. Choose a test; call the lab if any questions about test details, price or schedule.

2. Fill in a requisition, order or prescription form. Or, download this form: MFL Requisition.
Include on the requisition:
  • Patient's full name and date of birth
  • Patient contact info (phone or address) if desired
  • ICD10 diagnosis code (required)
  • Physician's name and your name, phone, FAX, address for results
  • Clinician signature (required)
  • Any other information relevant to this patient's test
3. Fax or mail the requisition:
Fax: 206.598-7135 Attn: MFL
Mail: Male Fertility Lab 354795 University of Washington 4245 Roosevelt Way, Room E179
Seattle, WA 98105, USA

4. Instruct your patient to call us for an appointment at 206.598.6358

5. Results will be faxed to the ordering provider. Patients who self-refer will receive results by mail. You may sign up for our e-care system to receive your results on line. Results will be available on UWMC EPIC / Mindscape / ORCA within 5-10 days.
Download our Reference Ranges: SA Reference Values 2013

Consultation with our Providers

Clinical consult: Thomas J. Walsh, M.D. Phone: 206.598.6358
Lab consult: Charles H. Muller, Ph.D., H.C.L.D. Phone (office): 206.543.9504 Phone (lab): 206.598.1018