Account Setup Form
Return your completed form using the "Getting Started With Us" instructions on this page. Download Adobe Reader to fill out and save your PDF form. You may alternately print it if you don't want to use the Adobe Reader.
Also, please review the info on our Electronic Signature Authorization Form on this page.
Order Collection Kits
Who Can Order Collection Kits?
Note to Patients: A physician's order is required to order testing from Diagnostic Solutions Laboratory. See Patient FAQs for more details.
Getting Started With Us
Setting up an account with us is free and it's easy to do. Simply download our Account Set-Up Form and fill it out. Adobe Reader is available here if you don't already have it to fill out the form electronically.
Return the Account Setup Form to us via one of the following methods:
- Fax: 470-239-5017
- Email: email@example.com
Existing Account Holders
Electronic Signature Authorization Form
The Electronic Signature Authorization Form (ESAF) must be signed by each ordering provider in your office in order for Diagnostic Solutions Laboratory to enter insurance claims for your patients. Once we have the signed signature authorization on file, you will not have to sign the Test Request Form each time you order testing for your patient. This form is used for any test order and Insurance/Medicare Claim.
The health care provider’s signature on the requisition proves to the patient’s Insurance that you intended to order the selected laboratory test(s). As a Medicare provider, Diagnostic Solutions Laboratory must obtain your signed order or documentation of intent to order diagnostic laboratory tests in order to comply with Medicare, other government payor, or any commercial insurance requirements.
The Electronic Signature Authorization Form will be kept on file. Orders added through the provider portal will be stamped with > signature on file < if drop-shipped directly to the patient.
Access and download the form below (PDF opens in a new window).
NOTICE TO CLINICIANS:
We offer free drop-shipment of kits directly to patients for qualified tests. This allows them to easily and conveniently collect their specimen at home, and send it back to the lab for immediate processing.
Tests That Qualify for Drop-Shipment Directly to Patients:
IMPORTANT: The SARS-CoV-2 Stool Analysis must be ordered by phone: (877) 485-5336.
This test is not currently available via our online portal.
DO NOT use the GI-MAP kit for SARS-CoV-2 testing, it IS NOT the same test.
Services provided are for laboratory testing only. No charge is incurred for ordering collection kits.
If you have questions, or need assistance, please feel free to call us at 877-485-5336.