Order Tests

Simple steps for ordering tests:

Required:

1. Download, fill-in and print the Test Requisition Form.
2. Write in the test name at the bottom of the Test Requisition Form.

OR

1. Download, fill-in and print the Test Requisition Form.
2. 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