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Pathology Test Request
Complete the form below to request your pathology tests.
Important Notes:
Some tests may require fasting
Your form will be for one company but you can use any pathology provider
Results will be sent to your email upon receipt
Processing time typically 2-4 hours
Patient Information
First Name
Last Name
Email Address
Phone Number
Date of Birth
Day
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Medicare Card Number
Pos
Expiry
Address
State
NSW
VIC
QLD
WA
SA
TAS
ACT
NT
Test Details
Tests Requested
Select the type of test you need
I would like a general health checkup
Why am I so tired/lethargic?
Do I have a respiratory virus?
What are my cholesterol levels?
I want to be ready for pregnancy
Am I Pregnant?
Do I have an STI?
Do I have a UTI?
Medical History
Hypertension
COPD/Emphysema
High Cholesterol
Type 2 Diabetes
Congestive Heart Failure
Osteoporosis
Previous Heart Attack
Chronic Kidney Disease
Previous Stroke
None
Reason for Tests / Additional Information
Confirmations
I understand that some of these tests may require fasting
I confirm that I will arrange to discuss my results with my usual doctor
I understand the bulk billing arrangements and that there may be out-of-pocket costs
Submit Pathology Test Request $21.95
