Phlebotomy Lab Sign Up Form

Phlebotomy Lab Sign Up Form

Sign up for extra lab days at our Maple Heights facility
Please fill out the form below and select a date/time that you would like to reserve.

You are allowed to bring in a volunteer to stick.

If you need to cancel your scheduled time, please do so no less than 24 hours prior to your reserved time. You can cancel by sending an email to info@mymedcert.com.

Please keep in mind that when you reserve a spot, you take that spot away from someone else who may want it. Do not sign up for a date/time unless you are reasonably sure that you can show up.

You should arrive in scrubs and make sure that you bring your stick log.
Full Name:*

First NameLast Name
Phone Number*

Area CodePhone Number
E-mail:*
Number of remaining sticks needed*
Appointment for Sticks*
Should be Empty: