Skip to main content

New Account Form

Provider Information

Name
Organization Type
Address
Test Type

Administrative Contact (optional)

Name

Next Steps:

  1. AccessDx Laboratory Sales Operations will send you a Client Intake Form and Business Associate Agreement from [email protected] via AdobeSign.
  2. Please review, sign, and submit both forms.
  3. AccessDx Laboratory Sales Operations will send you the fully executed forms once complete.
  4. You will be contacted by an AccessDx Laboratory team member for questions, kit requests, and portal training (if electronic ordering is selected).