Contact Info
1181 First Colonial Road, Suit 200
Virginia Beach VA 23454
(757) 425-1600
Direction
»
5320 Providence Road, Suit 100
Virginia Beach VA 23464
(757) 420-1414
Direction
»
1925 Glenn Mitchell Drive, Suite 200
Virginia Beach VA 23456
(757) 425-1600
Direction
»
About Us
Providers
Gynecology
Obstetrics
Teen Care
Hospitals
Digichart
Employment
Our website provides helpful information about our practice, our healthcare providers and the services we provide.
Request For Test Results
Want to check on a lab test and/or ultrasound results? You’re in the right spot!
Our office will respond by phone - and your test results are private. Results will never be posted or
stored on the internet
Virginia Beach Obstetrics and Gynecology will not sell or otherwise provide your name,
address or other information to any third parties.
* Fields in color or with asterisks are required.
*Last name:
*First name:
Person Completing this Form if OtherThan Patient:
Name:
Relationship:
*Home Phone:
Work phone:
Ext:
*Email:
*Date of birth:
mm
dd
yyyy
*My Provider:
Select one
Dr. William Martin
Dr. Lisbet Hanson
Dr. Mary Burns
Dr. Pamela Pyle
Dr. Reena Talreja
Dr. Jeannie Hilton
Dr. Amour Johnson
Dr. Caroline Felty
Dr. Fenney Kwan
Angela Simmons, PA
No Preference (First Available)
Please check all tests for which you would like results:
Common Tests:
Pap Smear
Beta hCG
Prenatal Labs
GC/Chlamydia
MSAFP Quad Screen
Urine Culture
Early Screen
FSH
Thyroid Levels
Blood Test
Other
Name and Location of Facility:
Additional requests:
Mammogram
Name and Location of Facility:
Additional requests:
Bone Density Test
Name and Location of Facility:
Additional requests:
Ultrasound
Name and Location of Facility:
Additional requests:
Biopsy report
Name and Location of Facility:
Additional requests:
Surgical Pathology
Name and Location of Facility:
Additional requests:
Other
Name and Location of Facility:
Additional requests:
If you’d like a copy of this request, please print this page before clicking Submit
Click Submit when complete - the form will be e-mailed to us
Thank You!
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