Patient Registration

Register here if you like to have access to our Patient Portal to view, download, and print your laboratory results rendered by FutureGeneration. This requires for you to register with an email and password.

Clinic/Location/Provider Name

Name

First Name

Last Name

Date of Birth

YYYY

Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

To gain access to our Patient Portal, please register using the link at the top of the page.

Phone

(###)

###

####

Required Relevant Information

Gender

Ethnicity

Race

Insurance Information

If you opt to pay out-of-pocket for services rendered, please put "Self" in the fields below.

Insurance Provider

Policy Number

I understand that I am responsible for the cost of laboratory services rendered if insurance does not cover the costs.

We value your rights and responsibilities and want to ensure your information will be safeguarded. If you have any clinical questions, please contact your provider.