Test Requisition
IRL Requisition Forms
Please complete an IRL requisition form with special attention to the following instructions:
- Fully complete the patient information portion. Please write legibly.
- Indicate the tests requested.
- Provide the name of the physician ordering the test. This is critical for timely and accurate reporting of test results.
- Provide complete billing information.
Inova Reference Laboratory Client
Services
703-504-3475
Fax: 703-504-7827