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Test Requisition Forms

Every lab order requires a test requisition form

When you receive a specimen collection kit from Platinum Diagnostic Lab, a Test Requisition Form is included. Upon sending a specimen for analysis, you must send a completed test requisition form with the specimen. On this form you need to indicate which test(s) should be performed, as well as patient information, physician information, payment method and insurance data. An incomplete form may prevent Platinum Diagnostic Lab from processing your order, which can delay your test results.

Download a blank or custom test requisition form below. Either can be returned with a lab testing order.

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