Simple steps for ordering tests:
Required:
- Download, fill-in and print the Test Requisition Form.
- Write in the test name at the bottom of the Test Requisition Form.
OR
- Download, fill-in and print the Test Requisition Form.
- Print the Test List and place a checkmark next to the desired test(s).
May be required:
- Complete the Financial Responsibility Form when commercial insurance is to be billed.
- Complete the Medicare Advance Beneficiary Notice of Noncoverage (ABN) Form as needed.
- Complete the Genetic Testing Consent Form. This form is required for NY State and can be used by anyone who would want to complete it.
Not required:
- The Specimen Collection and Shipping Information Form is available if needed.
When you have completed all necessary documents, send them along with the specimen to:
DDC Clinic Molecular Diagnostics Laboratory
14567 Madison Rd.
Middlefield, OH 44062