Patient Information

We need a few details to authorize your lab requisition. Your data is encrypted and visible only to your Optimum Care clinical team.

Your Name

First name*Last name*

Email*Phone (optional)

Date of birth*Biological sex*

Patients must be at least 18 years old. Biological sex is required by the testing lab to apply correct reference ranges.

Street address*Apt / Suite (optional)

City*State*ZIP*

By placing this order you confirm:

You consent to physician authorization of these lab tests.
This service is not for medical emergencies. Call 911 if experiencing a medical emergency.
You authorize Optimum Care to email you about this order.