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Adherence Monitoring
Pain Management
Mental Illness
Substance Use Disorder
Chronic Disease Management
BioDetect
Novel Psychoactive Substances
Aegis NPS Insights Dashboard
The Aegis Advantage
2024 NPS Summary
InterACT Rx
Sports Testing
Clinical Blood Testing
Infectious Disease Testing
Clinical Resources
About Definitive Testing
Clinical Updates
Webinars
Events
Patient Impact Stories
Publications
Reference Guide
Collection Instructions
Work With Us
Current Openings
About
The Aegis Difference
Executive Leadership
Scientific and Clinical Team
Testimonials
Lab Tour
News
Contact
Client Login
Pay My Bill
Clinical Drug Request Form
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Please enable JavaScript in your browser to complete this form.
Drug Name/Gene/Interaction
*
What Drug, Gene, or Drug-Drug Interaction would you like to request?
*
--- Select Choice ---
Drug-Drug Interaction
Urine
Oral Fluid
Blood
"YES", Gene, is
Specify your own value
Current Client?
*
Yes
No
If "YES", what is the client number?
Reason for request:
If this is not a one-time request, how often will this be requested?
*
This will be a one time test
This drug will be requested frequently
Submit
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