Semen Analysis Appointment Request

If you would like to have a Semen Analysis scheduled, please complete the form below.

Solicitud de Cita para Análisis de Semen

Patient First Name

Patient Last Name

Patient Email Address

Patient Birthday

Patient Phone Number

Name of Spouse / Partner

Spouse/Partner Birthday

Test Ordered

Complete Semen Analysis for Fertility - $250

Sperm Count - $100

Payment Options

Pay Online

Pay by Telephone

Physicians Name

Physicians Telephone Number

Physicians Fax Number

Test Requirements

Specimen must be brought to IML at 6419 Parkand Dr, Sarasota 34243 at your assigned appointment time.

Specimen must be collected no more than 30 minutes before appointment time and kept warm (body temperature) during transport.

Specimen must be collected off-site by masturbation or coitus interruptus. Submit entire collected specimen in clean, dry container provided by your physician or lab. Do not use a condom, lubricant or other contaminant during collection. Patient must refrain from ejaculation for 3 days prior to specimen collection.

Failure to adhere to Test Requirements may result in test cancellation and cancellation fee.

Your Information has been submitted.

INTERNATIONAL MEDICAL

LABORATORY

If you would like to have a Semen Analysis scheduled, please complete the form below.

Solicitud de Cita para Análisis de Semen

Test Requirements