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Specimen Collection Request
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Specimen Collection Request
Specimen Collection Request Form
Please complete the form to make a request
* Enter HCI Code
Example:
20M0163
, Click
here
to go to HCI Website
Retrieve Clinic Information
Clear HCI Code
Unable to retrieve clinic information, please contact PLS hotline at 65-62789188.
Despatch Code
Clinic Name
Street Address
Postal Code
Specimen Collection
* Collection Date/Time
Remarks
* Requested by
Clinic Staff Name
* Email
* Please tick to acknowledge and proceed with the submission.
Request for specimen collection will only be processed during Mon-Fri 8:30-16:30 / Sat 8:30-12:30. Forms submitted outside these hours will be processed on the next available working day. Please note that we are closed on Sunday and Public Holidays.
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