Get the free Laboratory specimen submission form Laboratory specimen submission form - sonoma-county

Lyme disease & other tick diseases County of Sonoma Department of Health Services Public Health Laboratory 3313 Chan ate Road, Santa Rosa, CA 95404 Telephone (707) 5654711 Lab no. date received: Patients

How to fill out laboratory specimen submission form

How to fill out a laboratory specimen submission form:

1. Start by filling out your personal information section, including your full name, date of birth, and contact information. This information is important for proper identification and communication.
2. Next, provide the details of the specimen being submitted. Include the type of specimen (blood, urine, tissue, etc.), the date and time of collection, and any relevant clinical information or symptoms that led to the testing.
3. Indicate the tests requested by checking the appropriate boxes or writing down the specific tests needed. Make sure to provide clear instructions and any additional information, such as the urgency or special handling requirements for the specimen.
4. If applicable, include any relevant history or medications that might impact the interpretation of the test results. This information helps the laboratory evaluate the results accurately.
5. Review all the filled-out sections and ensure that all the necessary information has been provided. Double-check for any errors or missing details. It is essential to be as accurate and thorough as possible when completing the form.

Who needs a laboratory specimen submission form?

1. Patients: Individuals who require diagnostic testing, monitoring, or screening may need to fill out a laboratory specimen submission form. This applies to both inpatient and outpatient settings.
2. Healthcare providers: Doctors, nurses, and other healthcare professionals typically request laboratory tests to aid in diagnosing and monitoring patients' conditions. They complete the submission form on behalf of the patient and provide the necessary clinical information.
3. Research facilities: Laboratories involved in scientific research may also require specimen submission forms to support their investigations. These forms help track and document the specimens received and provide researchers with valuable data for their studies.

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What is laboratory specimen submission form?

Laboratory specimen submission form is a document used to submit samples for testing or analysis in a laboratory.

Who is required to file laboratory specimen submission form?

Healthcare providers, healthcare facilities, or individuals collecting samples for testing are required to file the laboratory specimen submission form.

How to fill out laboratory specimen submission form?

To fill out the laboratory specimen submission form, one must provide information about the sample being submitted, including patient information, type of sample, and reason for testing.

What is the purpose of laboratory specimen submission form?

The purpose of the laboratory specimen submission form is to ensure that the laboratory has all necessary information to perform the correct tests on the sample and report accurate results.

What information must be reported on laboratory specimen submission form?

Information such as patient name, date of birth, gender, type of sample, date and time of collection, ordering physician, and reason for testing must be reported on the laboratory specimen submission form.