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Lab Work Questionnaire

Identification Information

Birthday
Month
Day
Year

Services

Type of Service Needed (Required)

Standard draw
Couple draw
Research lab draw kit
Specimen pick up and drop off
Therapeutic phlebotomy
Other

Service Location  (Required)

Single choice
Clinic
Hospital
Nursing home
Office/Work Place
Private residence

Lab Work

Do you have a doctor's order?  (Required)

Yes
No

Do you have a specialty kit?  (Required)

Yes
No

ATC Lab and Training LLC

Mobile Services Available

Serving Atlanta and Surrounding Counties

Phone: 770-299-0033

Fax: 404-620-0525

Email: office@atclabandtraining.com

Services​

  • Blood Draw

  • Breath and Alcohol Screening

  • CPR Training

  • DNA Testing

  • DOT/Non-DOT Urine Drug Screen

Company

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