Prolaris Test Request Forms

Print, complete and return the appropriate Prolaris Test Request Form (below), and we will handle the rest.

Prolaris Biopsy Test Request Form

Prolaris Post-Prostatectomy Test Request Form

Sample Test Request Forms

Below are examples of how your completed test request form should look. Please use these as a guide when filling out the test request form for your patient.

Prolaris Biopsy Sample Test Request Form

Prolaris Post-Prostatectomy Sample Test Request Form

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