Nationwide Access To Diagnostic Lab Tests

Phone: 1-888-531-2030 | Fax: 1-855-345-5222

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Virtual Consultation Service

How do virtual consults work?

In a virtual consult, a licensed provider will write an imaging order based on a virtual visit. A virtual consultation does not include a call and does not always allow for a back and forth discussion like a regular consult so you must be detailed and specific with your request. Once the order is generated, simply submit the lab order back to LaboratoryAssist, and we’ll take care of scheduling your labs.

What are the benefits of a virtual consult?

Virtual consults are quicker and more cost-effective than traditional in-person visits. However, they are not meant to replace the ongoing care provided by a primary care physician.

How long does it take to get a response?

After submitting your form, you should receive a referral within 2 business days.

Medical Necessity*

I understand that referrals are based on medical necessity guidelines. The medical provider could determine that alternate lab tests are needed.

No Guarantee*

There is no guarantee that participating labs can actually render the tests in the order written. No refunds will be provided.

Patient Information

Patient Name*

Please enter exactly as on your id. The name on the order can not be changed once issued.

First Last

Date of birth*

Gender*

Phone*

Email*

Address*

Street Address Address Line 2 City State Zip Code Country

Requested Lab Tests

Lab Tests Requested*

Add one test per line. Include test names only do not enter codes.
eg. Lipid Panel
If test codes are entered without the name of the test, provider will not write an order for that test.

Please provide a detailed narrative on why these tests are being requested?*

A detailed explanation for each test being requested must be provided.
One line responses are not sufficient. Aim to write at least a few paragraphs on the situation.

Product Name*

Billing Address*

Same as previous

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Total

Credit Card*

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Card Number

Expiration Date

Security Code Cardholder Name

Signature*

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ahg_la_user*

Comments

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Purchase Summary

Total Charges

$25.00

Payments

$0.00