SinclairMethod.org
1455 NW Leary Way Suite 458
Seattle, WA 98107
Tel: (888) 323-0575
Email: info@sinclairmethod.org
Please fax results to: (206) 707-8299
Name of Laboratory
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LabCorp
Quest Diagnostics
Laboratory FAX
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Patient's Name
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First Name
Last Name
Date of Birth
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Day
Year
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Patient's Phone
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Sex:
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Male
Female
LAB ORDERS:
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Hepatic Panel Function (7)
Gamma Glutamyltransferase (GGT)
Complete Blood Count (CBC) With Differential
Comprehensive Metabolic Panel
B Vitamins
Vitamin D, 25-Hydroxy
Serum HCG
Urine Toxicology
Diagnostic Code(s):
F10.10
Z79.899
Instructions to Client:
Signature
Yahya Saeed, M.D.
NPI: 1205005519
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