Patient Service Agreement
This Patient Service Agreement ("Agreement") is between Phleb-Finders, LLC ("Phleb-Finders") and the undersigned patient ("Patient"). This Agreement is effective as of the date signed below ("Effective Date").

  1. Services Provided: Phleb-Finders will arrange for a qualified phlebotomist to perform a one-time blood draw at the Patient's location.

  2. Fees and Payment:

    • If the blood draw is scheduled to occur within three (3) days of the request, the fee is $125 per person draw plus mileage for the contracted phlebotomist. Mileage will be coordinated ahead of time and approved before the blood draw takes place.

    • If the blood draw is scheduled with at least three (3) days' notice, the fee is $95 per person.

    • If more than one blood draw is required at the same location, mileage will only be billed once.

    • Payment must be made in full prior to the scheduled appointment and before the blood draw takes place.

      California and New York state will have a $30 fee added to blood draw for cost of living adjustments.

      At this time, we are unable to service the state of Nevada.

  3. Specimen Handling: Phleb-Finders ensures proper collection and transportation of the specimen to the designated laboratory. Any issues with the specimen must be reported to Phleb-Finders within five (5) days of the appointment.

  4. Patient Responsibilities:

    • The Patient must have the required blood draw kit on hand at the time of the appointment.

    • All necessary documentation, instructions, and requirements for the blood draw must be provided and adhered to before the phlebotomist arrives.

  5. Confidentiality: Patient information and clinical records will be kept confidential and used solely for the purpose of providing the agreed services.

  6. Independent Contractors: The phlebotomists are independent contractors and not employees of Phleb-Finders.

  7. Liability: Phleb-Finders is not responsible for any indirect or consequential damages arising from the services provided.

  8. Termination: Either party may cancel this Agreement within 48 hours of the scheduled appointment. If cancelled within the 48 hour scheduled window, the draw fee will not be refunded.

  9. Dispute Resolution: Any disputes will be resolved through binding arbitration in Peoria, AZ, under the rules of the American Arbitration Association.

  10. Governing Law: This Agreement is governed by the laws of the Commonwealth of Arizona.

Overview

Please provide your name, email, phone number, and address you wish the blood draw to be drawn at.
Please let us know if you blood draw needs to be drawn within 3 business days. If so, you will be charged at the STAT pricing of $125.
Mileage will be charged at $.72 per mile over 30 miles round trip. Do you have a dollar amount that you would like to preapprove? If not, we will reach out to you directly to get approval before sending an invoice.
By typing your name in the box below, you are agreeing to the Patient Services Agreement above.