Immunization Clinic Request Form

Immunization Clinic Request

Fill out the form below and a representative of Blue Ridge Scientific will be in touch to further discuss how we can help you!

THANKS FOR COMING TO BLUE RIDGE SCIENTIFIC FOR YOU BLOOD DRAW. YOUR LAB WORK WILL BE PROCESSED BY:

800-762-4344

866-MY-QUEST

YOUR RESULTS WILL BE SENT DIRECTLY TO YOUR PHYSICIAN; WE DO NOT RECEIVE RESULTS HERE.

YOU CAN ALSO CALL THE APPROPRIATE LAB ABOVE TO CHECK ON YOUR BLOODWORK/RESULTS IF NEEDED.

WALK IN INFO

{add text here}

Please bring all current medications and any secondary documentation from other medical providers. For example, 90-day CPAP compliance report, most recent A1C, or any return to duty release forms, if applicable, for your DOT or Non-DOT physical.
As a courtesy to our DOT drivers, you will receive a copy of your Long Form, Driver’s Certificate, and a card for your wallet.
Your Driver’s Certificate will also be faxed to the DMV on your behalf, but it is ultimately your responsibility. If the DMV fails to upload the fax, you will receive a notification.

LOOKING FOR YOUR DRUG TEST RESULTS?

Employer directed drug screens – Please contact your employer.

Court ordered drug screens – Please contact attorney, DSS, or CPS representative.

Individually purchased drug screen – Please contact our office.

WE ONLY RELEASE RESULTS TO INDIVIDUALLY PURCHASED DRUG SCREENS.

[email protected]

Search for: