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Urine Qualitative Pregnancy Test

$25

Used to confirm or rule out pregnancy.

Description: Human chorionic gonadotropin (hCG) is a two-chain glycoprotein hormone found in blood and urine only during pregnancy. It is secreted by placental tissue, almost from the time of implantation, and serves to support the corpus luteum during the early weeks of pregnancy.

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Patient Information

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First Name

Middle Initial

Last Name:

Address: (Street City, State, Zip)

Phone Number: (ex: 123-456-7890)

Date of Birth

Last 4 Digits of SSN:

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