Place an Order

Please complete the required fields below to place a blood work order with Advanced Sports Labs.  One of our representatives will contact you within the next 24 hours to finalize your order.

If you have placed an order online and have not yet received your confirmation either by email or phone, please DO NOT submit a second order online as this may result in 2 orders being processed. Please give ASL a call at 888-340-4644 so that this can be resolved quickly.

Fighter Information

First Name

Last Name

Date of Birth

Phone Number

Fighter's Email Address

IMPORTANT NOTE: This Email Address MUST belong to the Fighter who's name is mentioned above. If you are a not the fighter, DO NOT place your email address here, as this is the email address used in reporting the results.

It is against federal law to illegally obtain medical records or results without prior consent, in the form of a medical release form, being legally signed by the patient.

Street Address

City

State

Zip code

Pro or Amateur?

Record

Event Information

Event Name

Date of Event

State (where event is located)

Promoter Information

Promotion Company Name

Promoter's Contact Name

Promoter's Phone Number

Promoter's Fax Number

Promoter's Email Address

Gym / Manager Information

Gym Name

Gym Phone Number

Gym Address

Gym City

Gym State

Gym Zip Code

Trainer's Name

Blood Work Information

Which test would you like to order?

Who is paying for this blood work order?
The Fighter Listed AboveSomeone Else

Please enter the full name of the person paying for this blood work order

Terms of Service & Conditions

Advanced Sports Labs will be contacting you by email and phone to confirm this order. Advanced Sports Labs protects the privacy of our clients and will not sell, distribute, or share any information about our clients with third party's at anytime. In the Event of a Positive Result, on any blood work Advanced Sports Labs provides, we recommend that the patient consults with their personal physician.

IMPORTANT NOTE: The laboratory is obligated by federal law to report any positive HIV results to the proper authorities. If further testing for confirmation purposes is required, Advanced Sports Labs has the authorization to charge additional fees for further testing and it will be charge to the credit card on file.

I hereby acknowledge that I have read and accept the terms of service & conditions stated above. If further testing is required, I authorize Advanced Sports Labs to charge my credit card on file for additional fees for further testing.