Ordering HPV-SEQ for your patients

As the ordering physician, please complete this form and a member of our team will contact you to complete the order and provide additional details.
The HPV-SEQ test currently requires pre-payment. After we confirm the ordering details, the patient will be billed directly by Sysmex Inostics.
After payment is received, a blood collection kit will be shipped to the ordering physician. The kit contains all you need to collect and ship the sample back to our CLIA lab, including a TRF and FedEx shipping label.

*Sysmex Inostics will provide the test result to the ordering physician within 7-10 business days from receipt of the sample.

Institution name(Required)

Name(Required)

First name Last name

Phone(Required)

Email(Required)

ATTN:(Required)

Shipping address for sample collection kit:(Required)

Street address Address line 2 City State ZIP code

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Source Name

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UTM Source

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UTM Medium

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UTM Campaign

If you have questions or would like additional information, please contact us at:

Email: lab@sysmex-inostics.com
Phone: 1-443-759-8650

*In some cases, additional time should be allowed for re-tests. Testing schedules may vary.