Requisition Form

  • 1 Basic Info
  • 2 Sample Info

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This password will be used to open the final PDF report that will be emailed directly to you when the results are ready. Please make note of this password. This is not a PanoHealth website account password.
  •  None
  •  Z20.828 actual exposure COVID 19
  •  Z03.818 possible exposure to COVID 19
  •  R05 Cough
  •  R50.9 Fever, unspecified
  •  J98.9 Respiratory Disorder, Unspecified
  •  J06.9 Acute Upper Respiratory, Unspecified
  •  J22 Acute Lower Respiratory
  •  B99.9 Unspecified Infectious Disease
  •  J00 Acute Nasopharyngitis
  •  J01.90 Acute Sinusitis, Unspecified
  •  J02.9 Acute Pharyngitis, Unspecified