Wellness Lab Requisition Form

What is a Wellness Requisition Form?

Physicians use a wellness requisition form to test overall wellness or specific aspects of a patient’s health. Testing is broken up into separate categories for male and female patients. Once a blood sample is drawn, different panels are analyzed based on gender. The physician will then discuss test results and lifestyle recommendations with the patient.

A Wellness Requisition Form Includes:

  • Complete Blood Count
  • Complete Metabolic Panel
  • Hormones
  • Iron
  • Ferritin
  • Folate
  • Lipid Panels for Cholesterol
  • Magnesium
  • Vitamin B
  • Vitamin D

Female Testing Panels May Include:

  • Follicle-Stimulating Hormone (FSH)
  • Progesterone
  • Prolactin
  • Testosterone
  • Thyroid Stimulating Hormone (TSH)
  • Vitamin 12

Male Testing Panels May Include:

  • Cortisol
  • Human Growth Hormone (hGH)
  • Luteinizing Hormone (LH)
  • Prostate-Specific Antigen (PSA)
  • Testosterone

We offer several custom medical forms and lab requisition forms with design options and features tailored to your unique needs. Our clients include Drug Treatment Centers, General & Reference Labs, Home Health, Hospitals, Nursing Homes, Physicians & Providers, Wellness Centers & Clinics, and Nutritionists.

  • Custom Branding with your Logo
  • Tailored Layout Design
  • Multi-Part NCR Forms
  • 2-D Barcoding
  • Serialized Numbering
  • Integrated Labeling with Custom Die Design
  • Several Page Colors Available
  • Thousands of Pantone Ink Colors Available

Who We Are

Forms.MD specializes in the design & printing of custom requisition forms, custom integrated label form, and chain of custody forms, general printing, medical website design, branding and logo design, internet marketing, and Local Search Engine Optimization (Medical SEO). Our team of experienced professionals has worked with hundreds of small to enterprise level business on projects ranging from multi-site web development to national branding to product development. We value customer service and support above all. Contact us today!

Our Lab Requisition Forms Include: