Get the free GBS Specimen Submittal Form rev102209 - rivco-diseasecontrol

California Department of Public Health Viral and Ricketts Disease Laboratory GUILLAINBARR SYNDROME SPECIMEN SUBMITTAL FORM PLEASE USE ONE FORM PER PATIENT Please submit the following specimens for

How to fill out gbs specimen submittal form

How to Fill Out GBS Specimen Submittal Form:

1. Begin by clearly identifying the name and contact information of the healthcare facility or laboratory submitting the GBS specimen.
2. Provide the patient's information accurately, including their full name, date of birth, and any unique identifiers such as medical record number or social security number.
3. Indicate the relevant clinical information, such as the reason for the GBS specimen collection, any symptoms the patient is experiencing, or the indication for the test.
4. Specify the collection date and time of the GBS specimen.
5. Make sure to accurately document the type of GBS specimen collected, whether it is a vaginal/rectal swab, urine sample, or any other specified sample.
6. If applicable, note any previous antibiotic or antiviral therapy the patient has received prior to the specimen collection, as it may impact the GBS test results.
7. Include the name and contact information of the healthcare provider responsible for ordering the GBS test.
8. Read and comply with any specific instructions provided by the laboratory regarding specimen handling, transportation, or storage.
9. Double-check all the information provided before submitting the form to ensure accuracy and completeness.

Who Needs GBS Specimen Submittal Form:

1. Obstetricians and midwives: They often utilize the GBS specimen submittal form to test pregnant women for Group B Streptococcus (GBS) colonization. GBS screening during pregnancy helps identify women carrying the bacteria, which can cause serious complications for newborns during childbirth.
2. Labor and delivery units: Hospitals and birthing centers usually require the GBS specimen submittal form to be completed for every pregnant woman admitted for labor or planned cesarean section. This ensures proper screening and appropriate preventive interventions to reduce the risk of GBS transmission to infants.
3. Laboratories: Clinical laboratories receiving GBS specimens for processing and testing rely on the GBS specimen submittal form to gather essential patient and clinical information relevant to the diagnosis and reporting of GBS colonization. This form enables efficient laboratory workflow and accurate result interpretation.

For pdfFiller’s FAQs

What is gbs specimen submittal form?

The GBS specimen submittal form is a document used to submit specimens for testing for Group B Streptococcus.

Who is required to file gbs specimen submittal form?

Healthcare providers and facilities are required to file the GBS specimen submittal form when submitting specimens for testing.

How to fill out gbs specimen submittal form?

The GBS specimen submittal form can be filled out by providing the required information such as patient details, specimen type, and reason for testing.

What is the purpose of gbs specimen submittal form?

The purpose of the GBS specimen submittal form is to provide necessary information for accurate testing and diagnosis of Group B Streptococcus.

What information must be reported on gbs specimen submittal form?

Information such as patient demographics, specimen collection details, and relevant clinical information must be reported on the GBS specimen submittal form.

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