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Patient Service Center Information

Fairhope 919 Plantation Blvd Fairhope, AL 36532

Service Information
Total number of patients*	1 2 3 4	Please select the Number of Patients
Reason for Testing*	Select Covance Clinical Trial Employee Wellness with Body Measurement Employment Drug Screen Glucose Tolerance H. Pylori Breath Test Labwork (Routine Clinical) Lactose Tolerance Paternity (Patients do not schedule yourself. Call 1-800-742-3944 for an appointment.) Pediatric Specimen Drop Off Standing Order	Please select the Reason for Testing
Will you be fasting*	Select Yes No	Please Select Will You Be Fasting Or Not You may find a more convenient choice of appointments in the afternoon for non-fasting testing

Schedule Date / Time
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Date		Please enter the preferred Appointment Date. Please enter date in valid MM/DD/YYYY format. Sorry! You can only select appointment slots starting from today. Sorry! You can only schedule an appointment up to 90day(s) from today. Sorry! You cannot make an appointment on the selected date. Sorry! You can only schedule an appointment starting from 08/11/2010
Time	HH 01 02 03 04 05 06 07 08 09 10 11 12 : MM 00 15 30 45      AM PM	Please select the preferred Appointment Time.

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