New Account Setup Application

  • To order tests, the practitioner must be authorized under his or her scope of practice.
  • The ability to order laboratory testing is linked to a profession’s authority to interpret results for the purposes of diagnosis for decisions regarding patient treatment. If you are unsure whether your license covers the ordering of laboratory tests, please contact your State Department of Health, Health Professions Quality Assurance.
  • Please do not refresh the page while completing the form.
    1. You may fill out our secure Registration Form below and submit when all required fields are completed.
    2. This Practitioner Certification Form is available in PDF format.
      You may print and complete the form. The completed form may be mailed, faxed or emailed to our Client Services Department.
  • Step 1 of 3

  • Primary Account Information

  • * Our services are currently not available to practitioners in the state of NY & PA.

  • Step 2 of 3

  • Billing Information

  • * Bill me option available to USA customers only. (Credit card will be charged for any past due invoices)

  • Credit Card Information (Optional)

  • - I Understand that I am responsible for the interpretation of all US Biotek Laboratories test reports for my patients, and that I will use my clinical judgment based on my patient's history, symptoms and physical exam findings.

    - By electronically submitting this application I agree to its terms and conditions and certify that all the information is true and correct to the best of my knowledge.

  • Step 3 of 3

  • Account Setup

  • Preferred Report Delivery Method

    Please select all that applies

  • How did you hear about us?

  • Material and Kit Ordering

  • Note: We will contact you by email and fulfill your order once your account has been approved.