Schedule a Lab Appointment
Reason for Visit
*
Please Select
Routine Lab Visit
Therapeutic Lab Visit
For Therapeutic Lab Visits please call 240-566-3400 to schedule an appointment.
Select a Lab Location
*
Crestwood - 7211 Bank Ct, Frederick 21703
Emmitsburg - 16403 Old Emmitsburg Rd, Emmitsburg 21727
Mount Airy - 504 E. Ridgeville Blvd, Mt. Airy 21771
New Market - 10260 Silverside St, Ijamsville 21754
Rose Hill - 1562 Opossumtown Pike, Frederick 21702
Urbana - 3430 Worthington Blvd, Frederick 21704
Village - 1 Frederick Health Way, Frederick 21701
Frederick Health Crestwood | Laboratory
7211 Bank Ct
Suite 130
Frederick, MD 21703
Get Directions
Crestwood Appointment Request
*
Frederick Health Emmitsburg | Laboratory
16403 Old Emmitsburg Rd
Emmitsburg, MD 21727
Get Directions
Emmitsburg Appointment Request
*
Mt. Airy Health & Wellness Pavillion | Laboratory
504 E Ridgeville Blvd
Suite 105
Mt. Airy, MD 21771
Get Directions
Mt. Airy Appointment Request
*
Laboratory at New Market
10260 Silverside St
Suite 110
Ijamsville, MD 21754
Get Directions
New Market Appointment Request
*
Frederick Health Rose Hill | Laboratory
1562 Opossumtown Pike
Frederick, MD 21702
Get Directions
Rose Hill Appointment Request
*
Frederick Health Urbana | Laboratory
3430 Worthington Blvd
Frederick, MD 21704
Get Directions
Urbana Appointment Request
*
Frederick Health Village | Laboratory
1 Frederick Health Way
Specialty Suite 100
Frederick, MD 21701
Get Directions
Village Appointment Request
*
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Patient Information
Name
*
First Name
Middle Name
Last Name
Suffix
Birthdate
*
-
Month
-
Day
Year
Date
Language
*
Please Select
English
Arabic
Burmese
Chinese - Cantonese
Chinese - Mandarin
Farsi
French
Hindi
Korean
Portuguese
Russian
Sign Language
Spanish
Urdu
Vietnamese
Other
Other Language
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number. (mobile preferred)
Phone Type?
*
Mobile
Home
Work
Other
SMS Consent
*
Yes! Please text me (more verbage here)
No! Do not text me.
Address
*
Street Address
Street Address Line 2
City
State
Zip Code
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Order Details
A physician's order is required for all lab appointments. If you’d like to save time at your appointment, please upload your order now.
Ordering Provider
*
For Example: Dr. Jones (Provider Name) or Urbana Urgent Care (Office Name)
Reason for Visit
Physician's lab order
Browse Files
Drag and drop files here
Choose a file
OPTIONAL
Cancel
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Financial Details
Would you like to provide insurance for the person being tested?
*
I'll save time and provide it now.
The patient will bring insurance information to the appointment
The patient does not have insurance.
Primary Insurance Card(s) (optional)
Browse Files
Drag and drop files here
Choose a file
Please upload pictures of the front and back of the insurance card
Cancel
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Primary Insurance
Filling this out now will save you time at your appointment, getting you out the door quicker.
Insurance Provider
*
Policy Number/Member ID
*
Group ID.
*
Primary Subscriber's Relationship to Patient
*
Self
Spouse
Parent
Guardian
Other
Primary Subscriber's Name
*
First Name
Last Name
Primary Subscriber's Date of Birth
*
-
Month
-
Day
Year
Date
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Secondary Insurance
Do you have a secondary insurance?
*
YES
NO
Secondary Insurance Card(s) (optional)
Browse Files
Drag and drop files here
Choose a file
Please upload pictures of the front and back of the insurance card
Cancel
of
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Secondary Insurance
Filling this out now will save you time at your appointment, getting you out the door quicker.
Secondary insurance Provider
*
Policy Number/Member ID
*
Group ID
*
Secondary Subscriber's Relationship to Patient
*
Self
Spouse
Parent
Guardian
Other
Secondary Subscriber's Name
*
First Name
Last Name
Secondary Subscriber's Date of Birth
*
-
Month
-
Day
Year
Date
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Review your information
Appointment Date/Time
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Appointment Info
Calculation with Insurance
Calculation no insurance info
SF Mobile Number
Please enter a valid phone number. (mobile preferred)
SF Language
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