ACCOUNT SETUP FORM

Prior to sending any samples, you need to complete the Account Setup Form below, or there may be a delay in processing.
ACCOUNT SETUP FORM

CLIENT INFORMATION


TimeZone*
Facility Type*
Dymo Printing
Enable Auto Accession Generation

CONTACT INFORMATION


 
Critical Contact Details

Primary Physician Details



Primary Physician Signature

Special Requests


Specimen Pickup Information


UPSFEDEX
Pickup Time Requested: