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Michelson Laboratories, Inc ANALYSIS REQUEST FORM SOP No.: MLWIQC30.03 Control# GI 171 Authorized by: G. Michelson Revised on: 12×22/09-Page 1 of 1 Please Fill Out and Return with Sample’s) Company

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1. Start by gathering all the necessary information and documents you will need to complete the form. This may include personal information, medical history, or any relevant test results.
2. Carefully read through the instructions provided on the form. Make sure you understand each section and what is being asked of you. If there are any terms or definitions you are unsure about, consult the laboratory or seek assistance.
3. Begin filling out the form, starting with your personal information. This usually includes your full name, address, contact details, and date of birth. Double-check your information to ensure accuracy.
4. Move on to providing any medical history that may be required. This can include previous diagnoses, medications you are currently taking, or any allergies you may have. Be thorough and include any relevant details.
5. If the form requires you to provide test results, make sure you attach them or provide the necessary information accurately. This could involve entering the test name, date, and any related findings or values.
6. Fill out any additional sections or questions that may be specific to Michelson Laboratories. These could include preferences for receiving test results, payment options, or other specific requirements.
7. Review your completed form thoroughly for any errors or omissions. Ensure that all the information provided is correct and complete. Make any necessary corrections before finalizing the form.
8. Once you are satisfied with the content of the form, sign and date it as required. Follow any additional instructions provided regarding submission.

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