Vibrant Sample Requisition

The requisition form you will fill out depends on the type of samples you have.

  • If you have a test requiring a blood draw, see the instructions HERE.
  • If you have a test that doesn't require a blood draw, see the instructions HERE.
  • If you have a Vibrant Wellness test and are in New York, you must also fill out the Testing Release Form. Instructions HERE.

Tests Requiring a Blood Draw

Follow these instructions if you have a test requiring a blood draw. 

How to Fill Out Your Requisition

NOTE: If you are a pediatric patient collecting the Renal Function Panel or Comprehensive Metabolic Panel, please write your height on the requisition form.

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How Your Completed Requisition Should Look

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Tests Not Requiring a Blood Draw

Follow these instructions if you have a test requiring a blood draw.

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Testing Release Form

This form is only required for patients in New York. You can find this paper in the same place as your requisition form.

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