Test Reqest Form

Fill out the request form below to order a test. You will be contacted shortly afterwards to verify your order, after which your order will be successfully placed.

Have you already ordered a test?
Click here to check Order Status.

Select Test


Patient Information

    
Your gender is required.
Your date of birth is required.

Contact Details

ⓘ   Ensure accuracy of Contact Information, it will be used for Order Confirmation and Results Delivery.

Specimen Information


Referring Institution




  Need Assistance?

  Contact us:
  contact@precisiondiagnosticlab.com

  

 How it works

  • Step 1
    Request for a Test Online
  • Step 2
    Deliver Sample to our Collection Center
  • Step 3
    Get Your Results via Email