First Name *

Last Name *

Clinic Name *

Phone *

Email *

State Your Practice Resides In *

Do you already have an Evexia Account? *

Yes

No

Are you currently a P2P customer? *

Yes

No

Which EMR do you currently use? *

Athena Health

Cerbo

Charm

Dr Chrono

Jane

Optimantra

Paper

Practice Fusion

PrognoCIS

Proxia

Other

Select the top labs you currently use. *

3x4 Genetics

Boston Heart Diagnostics

Access Medical Labs

AllClear Healthcare

Diagnostic Solutions Laboratory

Doctor’s Data Inc.

ELISA/ACT Biotechnologies

Enbiosis

Flore Clinical

Genova Diagnostics

IGeneX

Infinite Allergy Labs

Kashi Clinical Laboratories

KMBO Diagnostics

LabCorp

MedToxLqaboratories

Mosaic Diagnostics (Formerly Great Plains Laboratory)

MyMycoLab

Namida

OmegaQuant

Physicians Lab

Precision Analytical (DUTCH)

Quest Diagnostics

Quicksilver Scientific

RealTime Laboratories, Inc.

SpectraCell Laboratories

Toolbox Genomics

TruDiagnostics

US BioTek Laboratory

ZRT Laboratory

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Important Notice: Evexia Diagnostics laboratory ordering services are currently unavailable in NY, NJ, and RI, and all revenue growth models are subject to applicable state and federal regulations. However, providers offering telemedicine services in other eligible states are encouraged to sign up.