Start your request—not your payment.

A valid physician/provider requisition is required before invoicing, payment, appointment confirmation, or specimen collection.

Required workflow

Request serviceSubmit requisitionReviewInvoiceUpfront paymentAppointment confirmedCollection

Step 1 — Basic request

Tell us how to contact you.

The basic email request collects only contact information, service category, general location, and scheduling preferences. Do not send medical records or protected health information by ordinary email.

Basic requests connect tokatrina@phlebotomynerds.info

Prefer to call? 734-787-1756

Full namePhone number

Email addressWhat are you contacting Phlebotomy Nerds about?Service city / ZIP code or facility name

Preferred dayPreferred time of day

How should we contact you?

Basic request onlyDo not email a date of birth, diagnosis, provider order, laboratory requisition, full home address, or other medical details through this form. After the basic request, use only the approved secure requisition-upload link supplied by Phlebotomy Nerds.

This is a service request—not a confirmed appointment, medical intake, invoice, or payment page.

Step 2

Upload Provider Requisition

The Dropbox File Request has been created. Patient uploads will activate after the qualifying healthcare/business account configuration and required BAA/security setup are confirmed.

Do not email or place patient documents in an ordinary website folder.

Steps 3–6

Review, invoice, pay, confirm

Phlebotomy Nerds reviews the service request, requisition, location/travel, availability, and applicable charges. An invoice is then sent directly to the customer.

Mobile Service — $___Travel Fee — starts at $38; final amount based on location and distanceTotal Due Upfront — $___

All required payments are due upfront. Your appointment is confirmed after your provider requisition has been reviewed and your invoice has been paid.

Stripe invoicing — connection ready / authorization neededPayPal Business & POS — connection ready / authorization neededWebsite payment disabled — invoice only