Navigating the requirements for health and immunity documentation can be a significant aspect of managing health records, especially for students and professionals in fields requiring clear health statuses. The Price Of Titers At Quest form stands out as a crucial document in this process, providing a streamlined way for individuals to request and pay for essential titer tests. These tests, which include Rubella, Rubeola (Measles), Mumps, and Varicella, along with the Hepatitis B Surface Antibody test for those who have completed the Hepatitis B vaccine series, come at specified costs. An additional mandatory blood drawing charge is also noted on the form, making it clear what the total financial commitment will be. The use of money orders or cashier’s checks as the only accepted forms of payment emphasizes the structured approach to handling these requests. This form not only facilitates the submission and payment process for these critical tests at Quest Diagnostics but also provides clarity on the costs involved, ensuring individuals can manage their finances accordingly in preparation for meeting necessary health documentation standards.
Question | Answer |
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Form Name | Price Of Titers At Quest Form |
Form Length | 1 pages |
Fillable? | No |
Fillable fields | 0 |
Avg. time to fill out | 15 sec |
Other names | quest diagnostics requisition form, quest diagnostics home draw form pdf, quest home draw forms, quest diagnostics requisition form download |
QUEST DIAGNOSTICS
TITER REQUISITION ORDER FORM
Name |
SSN |
Street Address
City
State
Zip
Daytime Phone Number
Email Address
If not a Chicago student, what is your regional site?
Name of Test |
Cost of Test |
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Amount Enclosed |
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Rubella Titer |
$11.00 |
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Rubeola (Measles) Titer |
$17.00 |
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Mumps Titer |
$17.00 |
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Varicella Titer |
$16.50 |
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Hepatitis B Surface Antibody |
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(only request this test if you have already finished |
$13.50 |
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the 3 vaccine Hepatitis B series) |
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Blood Drawing Charge |
$15.00 |
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$15.00 (required) |
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TOTAL AMOUNT ENCLOSED |
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Money order or cashier’s check only – |
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payable to “UIC College of Nursing” |
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NO CASH OR PERSONAL CHECKS PLEASE |
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Please return this form with payment to: |
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UIC College of Nursing |
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Attn: Immunity Records – Room 138 |
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845 S. Damen Ave. (MC 802) |
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Chicago, IL 60612 |
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