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Partner Registration
To become a new testing partner with Patients Choice Laboratories, simply fill out the form below. Once submitted, a member of our team will reach out within 24 hours.
We are excited about partnering with you for your testing needs!
Organization Information
Organization Name
Phone
Location Name- If more than one location
Fax
Street Address
City
Street Address Line 2
State
Zip code
Office Contact
Full Name
Email
Position
Contact Phone
Ordering Preferences
Select method you prefer to order tests.
Electronically through Copia Portal (will require training)
Paper Requistions
Name of person entering orders
Contact Number
Email
Report Preferences
Select the method you prefer to recieve patient results.
Copia Portal- For Admins
Patient Portal- Sent to email of patient
Office Fax
Office Contact
FedEx Shipping Preferences
Pickup Preferences
Scheduled Pickup
On-Call Pickup
Courier Service (approval required)
Pickup Time (minimum 2-hour window)
Pickup Days (select multiple days if needed)
Monday
Tuesday
Wednesday
Thursday
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Saturday
Estimated Monthly Volume
COVID TESTS
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Thank you! A member of our team will reach out within 24-hours.
