Request Lab Orders

Name

Date of Birth

Phone Number

Email

Which lab?

Labcorp
Quest
Other

Which other lab facility?

We realize you may not know exactly what you need, however take your best guess, we will contact you if we have any clarifications.

Which labs? Check all that apply.

"The Usual" - the same as you always get
Thyroid
Other

Which "other" labs do you need?

Insurance Plan

Same as last year
New plan
UHC
Cigna
Aetna
BCBS
Humana
Medicare/Medicare Advantage
Marketplace
Cost Share
Other

What "other" plan? (Include Member ID)

We will send you the lab order via email or portal.