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Aerodiagnostics Sample Requisition
Updated over a week ago

PLEASE PRINT THE REQUISITION FORM FROM YOUR RUPA PATIENT PORTAL AND SEND IT BACK WITH YOUR SAMPLES.

DO NOT FILL OUT THE BLANK FORM THAT COMES IN YOUR TEST KIT. It will not have all of the lab's required information. If you use the blank form, you may be required to recollect your samples.

How to Complete Your Requisition Form


How Your Completed Requisition Should Look

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