Sample Requisition Forms

These requisition forms are samples and the actual forms are subject to change. Please check with your BakoDx representative for the latest versions.

Dermatology req form

BakoID COVID-19, Influenza A/B, Antibody Sample Requisition Form

DermSTAT req form

BakoDx DermSTAT™ Sample Requisition Form

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Bako Diagnostics, as a partner to your practice, provides learning resources to help you better serve your patients. The information contained within this document should be used at a physician’s discretion. Bako Diagnostics assumes no liability for its content.