Testing Request for your Clinician
The Testing Request for your Clinician form allows you to request tests/profiles to be ordered by your personal healthcare provider. Follow the step-by-step instructions below to fill out the Testing Request for Your Clinician (PDF).
If your clinician is unable or unwilling to arrange the selected tests/profiles for you, please refer to our Clinician Referral Program.
- Fill out the top section with your name and select the test(s) requested.
- Fill out the bottom section with your Clinician's Name, address, and contact information.
- Print the form and bring it to your clinician as a request for testing.
- The form provides your clinician information to contact Metametrix for testing details, to establish an account, and to order your requested testing.