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421200833105EMPLOYEE VOUCHER for:____________________________Take this voucher to any Quest Diagnostics Patient Service CenterFor best results do not eat for 10 hours before testing time. You may have water and medication. Lehigh University Select Client # 18015408Visit us online at appointment To find a location and schedule an appointmentor call 1.888.277.8772Appointments are strongly encouraged during this time, but walk-ins are welcomeat our offices.Any questions please call the Health Screen Dept. at 1-800-776-6342PSC staff: Please enter ALL patient demographics including mailing address.NOTE; PSC refer to instructions for Industrial Programs00EMPLOYEE VOUCHER for:____________________________Take this voucher to any Quest Diagnostics Patient Service CenterFor best results do not eat for 10 hours before testing time. You may have water and medication. Lehigh University Select Client # 18015408Visit us online at appointment To find a location and schedule an appointmentor call 1.888.277.8772Appointments are strongly encouraged during this time, but walk-ins are welcomeat our offices.Any questions please call the Health Screen Dept. at 1-800-776-6342PSC staff: Please enter ALL patient demographics including mailing address.NOTE; PSC refer to instructions for Industrial Programs26172003436090DO NOT ADD A DRAW-FEE00DO NOT ADD A DRAW-FEE38196001477690__X__ A0216 HEALTH SCREEN _______ 899 TSH ($25.00) _______ 5363 PSA ($25.00) _______ 17306 VIT D ($35.00) 00__X__ A0216 HEALTH SCREEN _______ 899 TSH ($25.00) _______ 5363 PSA ($25.00) _______ 17306 VIT D ($35.00) 5292001477690 HEALTH SCREEN PANELNO payment required - do not add any tests that are not checked off00 HEALTH SCREEN PANELNO payment required - do not add any tests that are not checked off ................
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