Requestor Code Creation Form

Practice and Requestor Registration Form


If you are new to Labtests please complete the Requestor Code Creation Form.  Once completed, return form to our email address This email address is being protected from spambots. You need JavaScript enabled to view it. or by fax to 09-574 7284


Once we receive the completed form, one of our representatives will be in touch to further process and validate your application.