QuickDraws Mobile Lab
Form
Do You Need A Form?
To successfully fax over a service request, please read this page entirely.
Service requests will only be accepted via fax. Our fax number is (513) 541-2198. Any service requests sent after 4 PM will be viewed the following business day.
All Lab Requisition forms must have a physician’s signature.
If you’re unable to complete the Lab Requisition form, you will need to fax over the following items: Physician’s Order, Patient Demographic Sheet, Primary and Secondary Insurance Information.
If you have any questions or concerns please call us at (513) 202-3410.
Lab Requisition Form
The Lab Requisition Form can be used as a service request if completed, signed, and faxed to us. Click below to complete and print your lab requisition form.
Drug Screening Form
This form involves obtaining the individual’s information to set up a drug test. Please complete the form and a technician will contact you to provide assistance.