Register

Your Personal Details

Gender:

Male Female *

The normal range for blood tests is different for males and females. Gender is a required field.

First name: *

Middle name:

Last name: *

Date of birth:

Email: *

Your email address will be your login ID.

Confirm Email: *

Last 4 digits of your SSN: *

The last 4 digits of your SSN are required.

Your Address

Street address 1: *

Street address 2:

ZIP / postal code: *

City: *

Country: *

State / Province: *

Your Contact Information

Phone: *

Milestone Health Direct may need to contact you about your results. Please provide the best phone number for us to reach you.

Communication Preference

Receive Promotional Emails

Receive an Email when your lab results are ready

Receive on SMS Text Message when your Lab results are ready

Enter a Mobile Phone number where we can send SMS Text Messages. Standard text messaging rates apply

I wish to receive my lab requisition via email

(By un-checking this box you will need to either print your lab requisition or be able to show it on your cell phone when you arrive at a PSC)

Payment Options