Please read the following directions before filling out the requisition:
- Your facility name is automatically filled out.
- The form can be filled out and printed or you can print out a blank form and fill in the form by hand.
- Fill out the form completely – all blanks need to be filled in.
- Print the form, attach patient face sheet (for insurance information) and include with specimen.
- Place in pre-labeled shipping package and notify UPS of pending pickup
- Contact email@example.com or call 573-777-8600 with any questions or concerns