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IGeneX Inc. Reference Laboratory 795 San Antonio Road Palo Alto CA 94303 Tel 800 832-3200 Fax 650 424-1196 AUTHORIZATION RELEASE FOR PROTECTED HEALTH INFORMATION TO DATE IGeneX Inc. Reference Laboratory NO. OF PAGES INCLUDING COVER Palo Alto CA 94303 Tel 800 832-3200 Fax 650 424-1196 SUBJECT I hereby authorize IGeneX Inc. Reference Laboratory to release a copy of my medical records PATIENT NAME ADDRESS DATE OFBIRTH Patient/ Guardian Signature Today s Date Please send copies of test...

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Who needs igenex inc?

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Igenex Inc is needed by individuals who require specialized diagnostic testing and analysis for tick-borne diseases.

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Those who suspect they may have contracted diseases such as Lyme disease, babesiosis, Bartonella, or other tick-borne illnesses often seek the services provided by Igenex Inc.

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What is igenex inc?

igenex inc is a specialized clinical laboratory that focuses on testing for tick-borne diseases.

Who is required to file igenex inc?

igenex inc is a private company and is not required to be filed by any specific entity.

How to fill out igenex inc?

igenex inc is filled out by the laboratory staff who perform the testing and reporting of results.

What is the purpose of igenex inc?

The purpose of igenex inc is to provide accurate and reliable testing for tick-borne diseases to healthcare providers and patients.

What information must be reported on igenex inc?

igenex inc typically includes patient information, test results, and any necessary documentation for accurate reporting.

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