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I am requesting Direct Access Testing through My Lab ReQuest. I do not have a physician order for these tests. I understand that only I will receive the testing results. Sonora Quest Laboratories may share the test results with my physician or other providers only in critical or emergent situations or as required by law.
I understand that certain patient test results are required by Arizona Administrative Code (R9-4-302 and 404.H. and R9-6-204) to be reported to the Arizona Department of Health Services (AZDHS) for public health reasons. For selected results marked with a bell icon on the test menu, a local or state public health investigator may contact me for additional information or to ensure proper treatment. If I receive a positive test result for a sexually transmitted disease or tuberculosis, I understand it is my responsibility to consult with my doctor and/or contact my county health department’s STD clinic or main office.
I am age 18 or older. If < 18, I am an emancipated minor or otherwise authorized to request and provide consent for the tests ordered below. If I am requesting testing for which a minor is required by law to consent, the minor has consented to such testing.
I understand that Arizona law prohibits laboratories from billing health insurance for patient ordered laboratory testing. I further understand that these tests are not covered by Medicare as Medicare does not cover laboratory testing without a physician order. Full payment is due at time of service.
I understand that it is solely my responsibility to promptly discuss all laboratory results with a physician and that neither Sonora Quest Laboratories nor its Medical Director will provide interpretation, counseling, consultation, or care recommendations on the basis of any laboratory results provided to me. I release from liability and will not hold Sonora Quest Laboratories LLC or its Medical Director responsible if I do not promptly communicate the results of these tests to my physician.
If I choose to pay in advance for My Lab ReQuest testing and do not visit a Sonora Quest Laboratories Patient Service Center for sample collection within 60 days of payment, I understand that the prepaid amount will be automatically refunded.
If I have an outstanding balance with Sonora Quest Laboratories from a separate date of service, I authorize Sonora Quest Laboratories to apply my prepaid My Lab ReQuest refund toward that balance, with any remaining refund, if available, being processed.
I understand that refunds will be processed 12-15 business days from my order expiration date.
I am requesting this testing through the standing order provided by Sonora Quest Laboratories, powered by My Lab ReQuest. I do not have a physician order for these tests. I understand that I will receive the testing results. Sonora Quest Laboratories may share the test results with my physician upon request, insurance provider, or other providers or as required by law.
I understand that this test result is required by Arizona Administrative Code (R9-4-302 and 404.H. and R9-6-204) to be reported to the Arizona Department of Health Services (AZDHS) for public health reasons. A local or state public health investigator may contact me for additional information or to ensure proper treatment. If I receive a positive test result, I understand it is my responsibility to consult with my doctor and/or contact my county health department.
I am age 18 or older. If <18, I am an emancipated minor or otherwise authorized to request and provide consent for the tests ordered below.
I understand that this testing is being performed under a standing order provided by Sonora Quest Laboratories and will be billed to my insurance, or to Health and Human Services if I am uninsured.
I understand that it is solely my responsibility to promptly discuss all laboratory results with a physician and that neither Sonora Quest Laboratories nor its Medical Director will provide interpretation, counseling, consultation, or care recommendations on the basis of any laboratory results provided to me. I release from liability and will not hold Sonora Quest Laboratories LLC or its Medical Director responsible if I do not promptly communicate the results of these tests to my physician.
I am requesting Direct Access Testing through My Lab ReQuest. I do not have a physician order for these tests. I understand that only I will receive the testing results. Sonora Quest Laboratories may share the test results with my physician or other providers only in critical or emergent situations or as required by law.
I understand that certain patient test results are required by Arizona Administrative Code (R9-4-302 and 404.H. and R9-6-204) to be reported to the Arizona Department of Health Services (AZDHS) for public health reasons. For selected results marked with a on the test menu, a local or state public health investigator may contact me for additional information or to ensure proper treatment. If I receive a positive test result for a sexually transmitted disease or tuberculosis, I understand it is my responsibility to consult with my doctor and/or contact my county health department’s STD clinic or main office.
I am age 18 or older. If <18, I am an emancipated minor or otherwise authorized to request and provide consent for the tests ordered below. If I am requesting testing for which a minor is required by law to consent (noted by ), the minor has consented to such testing.
I understand that Arizona law prohibits laboratories from billing health insurance for patient ordered laboratory testing. I further understand that these tests are not covered by Medicare as Medicare does not cover laboratory testing without a physician order. Full payment is due at time of service.
I understand that it is solely my responsibility to promptly discuss all laboratory results with a physician and that neither Sonora Quest Laboratories nor its Medical Director will provide interpretation, counseling, consultation, or care recommendations on the basis of any laboratory results provided to me. I release from liability and will not hold Sonora Quest Laboratories LLC or its Medical Director responsible if I do not promptly communicate the results of these tests to my physician.
I understand that certain abnormal test values are considered “critical” because they may (but do not necessarily) indicate the presence of a potentially life threatening condition requiring immediate medical attention. I understand that Sonora Quest Laboratories will notify me by phone of any critical result upon completion of testing, at any time of the day or night.
Your laboratory test request form will be valid for 60 days.
Please print your laboratory test form and take it with you to any of our Patient Service Centers located conveniently throughout Arizona.
While appointments are not required at most locations, you can schedule an appointment now to help you save time.
Follow instructions on the form if fasting is required for the testing you are ordering.
Would you like to schedule an appointment now to save time?
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We are unable to process payments at this time, but your My Lab ReQuest order has been saved. You can still pay for this order at a later time by going to the "My Order History" section of your patient dashboard. Thank you!
Please print your laboratory test form and take it with you to any of our Patient Service Centers located conveniently throughout Arizona.
While appointments are not required at most locations, you can schedule an appointment now to help you save time.
Follow instructions on the form if fasting is required for the testing you are ordering.
Would you like to schedule an appointment now to save time?
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Please try changing your search parameters or complete the form below to suggest an addition to our My Lab ReQuest test menu.
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Thank You
Thank you for submitting your request for us to add new testing to our My Lab ReQuest menu. We continually look to expand this menu and will take your request into consideration.
You can pay online or pay at the Patient Service Center. Full payment is required before sample collection is performed. We accept all major credit cards, checks, and cash.
IMPORTANT NOTE: Your order is not complete until you schedule your appointment. Click the Next button to schedule your appointment and complete your order.
Note that there is no charge for this test as testing will be billed to insurance under a medical standing order for both insured and uninsured patients.
Thank you for ordering your COVID-19 Diagnostic - No Symptoms test.
You can pay online now or when you arrive at your appointment location. Full payment is required before sample collection is performed. We accept all major credit cards, checks, and cash.
Please note: your appointment HAS NOT been scheduled yet. You must proceed to the next step to schedule and book your appointment.