Parkway Lab

样本采集申请

请填写表格以提出请求

* Enter HCI Code Example: 20M0163, Click here to go to HCI Website

Clinic Name

Street Address

Postal Code

Specimen Collection

* Collection Date/Time

Remarks

* Requested by Clinic Staff Name

* Email

Request for specimen collection will only be processed during Mon-Fri 8:30-16:30 / Sat 8:30-12:30. Forms submitted outside these hours will be processed on the next available working day. Please note that we are closed on Sunday and Public Holidays.