Email Name First Last HiddenNP Reference Driver License and Lab Results are needed prior to your scheduled medical consultation Driver LicenseDriver License Number Driver License – State IssuedPlease choose stateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginia[E]WashingtonWest VirginiaWisconsinWyomingDistrict of ColumbiaAmerican SamoaGuamNorthern Mariana IslandsPuerto RicoU.S. Virgin IslandsDate Expires MM slash DD slash YYYY Driver License UploadIn order to prescribe most of the medications we carry, we must have a copy of your ID on file. Please upload a copy of your Driver Licence. If you would prefer, you can email it to Tiffanie@vikingalternative.com. Drop files here or Select files Accepted file types: pdf, png, jpg, jpeg, svg, wdp, heic, webp, Max. file size: 256 MB. Laboratory Blood TestingInitial Labs should include – at the very least – CBC, CMP, Testosterone, PSA and Estradiol. The tests are legally required to be no more than 6 months old are necessary for your medical provider to design and prescribe a protocol for you. Your labs must also clearly show your name and date of birth. Depending on your individual situation, our medical team may request new testing be done or that additional tests are required..My Laboratory Blood Tests I have recent blood laboratory testing results and will upload it here for review. I have recent blood laboratory testing results and will email the results to Tiffanie@Vikingalternative.com. I need a prescription for laboratory blood testing – please contact me. Viking Alternative Medicine has partnered with both Labcorp and Quest Labs to provide the necessary testing at an affordable cost. You can view the locations of both laboratories by clicking on the logos below. My Lab Preference is Quest LabCorp If you have recent (within the last 6 months) laboratory blood results please upload them here:Viking’s Medical Staff will review your submitted labs and determine if they are sufficient to use for your initial consultation. During the consultation, your provider may request additional testing. The initial testing is to enable the provider to evaluate your condition and proceed with your health care. Drop files here or Select files Accepted file types: pdf, png, jpg, jpeg, svg, wdp, heic, webp, Max. file size: 256 MB.
