Get the free MISUNLABELED SPECIMEN FORM - oregon providence

PROVIDENCE REGIONAL LABORATORY SERVICES PORTLAND SERVICE AREA pH: 5032156555 FX: 5032156127 PPM PS VMC PMH OTHER: MIS/UNLABELED SPECIMENS DIFFICULT RECOLLECTION To assure Patient safety two separate

How to fill out misunlabeled specimen form

How to fill out misunlabeled specimen form:

1. Start by clearly identifying the specimen being submitted. Provide as much information as possible, such as the patient's name, date of collection, and specific test being requested.
2. Next, indicate the reason for the mislabeling. Was it due to an error during collection, transportation, or processing? Clearly state the circumstances surrounding the mislabeling to ensure accurate handling of the specimen.
3. Provide any additional relevant information, such as the type of container used, any special handling requirements, or specific instructions for the laboratory staff. This will help ensure proper processing and testing of the specimen.
4. Include all necessary contact information, such as the name and phone number of the submitting healthcare provider, in case any clarification or additional information is required.
5. Finally, sign and date the form to attest to the accuracy of the information provided and to acknowledge that the specimen was indeed mislabeled.

Who needs a misunlabeled specimen form:

1. Healthcare providers or medical staff who have encountered a mislabeled specimen during the collection, transportation, or processing stages.
2. Laboratories or testing facilities where the mislabeled specimen needs to be processed or tested.
3. Quality control or compliance departments within healthcare organizations that require documentation of mislabeled specimens for record-keeping or auditing purposes.

For pdfFiller’s FAQs

What is misunlabeled specimen form?

The misunlabeled specimen form is a document used to report specimens that have been incorrectly labeled or identified.

Who is required to file misunlabeled specimen form?

Any individual or organization that comes across mislabeled specimens is required to file the misunlabeled specimen form.

How to fill out misunlabeled specimen form?

The misunlabeled specimen form must be filled out with the details of the incorrectly labeled specimen, including the correct identification information.

What is the purpose of misunlabeled specimen form?

The purpose of the misunlabeled specimen form is to ensure that accurate information is recorded for each specimen and to prevent errors in identification.

What information must be reported on misunlabeled specimen form?

The misunlabeled specimen form must include details such as the specimen ID, the incorrect labeling information, and the correct labeling information.

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