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Syphilis Confirmatory Testing Form: ATTN: Montana State Public Health Lab A syphilis screening test (Syphilis Antibodies Egg and IGM by ELISA) has been performed by Bozeman Health Laboratory Services.
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How to fill out syphilis confirmatory testing form
How to fill out syphilis confirmatory testing form
01
Obtain the syphilis confirmatory testing form from the appropriate healthcare facility.
02
Fill in the patient's personal information, such as their name, date of birth, and contact information.
03
Provide details about the healthcare provider ordering the test, including their name, contact information, and healthcare facility.
04
Indicate the date and time the form is being filled out.
05
Specify the testing method being requested, such as Treponemal-specific assays (e.g., FTA-ABS, TP-PA) or non-treponemal assays (e.g., RPR, VDRL).
06
If applicable, mention any previous syphilis test results or treatment history.
07
Sign the form to acknowledge the accuracy of the provided information.
08
Submit the completed form to the appropriate healthcare provider or laboratory for testing.
Who needs syphilis confirmatory testing form?
01
The syphilis confirmatory testing form is typically required for individuals who have initially tested positive for syphilis using a screening test.
02
It is used to confirm the presence of syphilis infection and provide additional information for proper treatment and management of the disease.
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