Lab Request Do not Use

    This form is for OFFICES, CLINICS, LABORATORIES and PROVIDERS to have a Laboratory Sales Representative contact you regarding becoming a Spectrum Health Laboratory Client.

    If you need to discuss private or sensitive patient information, or for specimen pickups, add-on test and urgent requests please contact 616.774.7721.

    This email is monitored Monday – Friday 9 am – 4 pm, excluding holidays. You will be contacted within 1 – 3 business days.

    For JOB OPENINGS or JOB SHADOWS, please visit the Spectrum Health Careers page.

    Your First and Last Name (required)

    Office Name (required)

    Phone Number (required)

    Secondary Phone Number (optional)

    Fax Number (required)

    Your Email (optional)


    Request (In accordance with HIPAA, do not include Patient Health Information)

    Note: This is not a secure form. Please do not use this online form to send health information about a patient. For more information review our Patient Privacy Policy.