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New York State Department of Health Wadsworth Center Specimen Request Form Public Health Research and/or Test DevelopmentNewborn Screening Form: Pol_5.5 Version 1.0 Effective Date: July 30, 2012NEWBORN
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01
Gather all the necessary information and materials for filling out the delayed specimens form.
02
Start by providing your personal details such as your name, address, date of birth, and contact information.
03
Specify the details of the delayed specimen, including the type of specimen, the date it was collected, and any relevant identifying numbers or codes.
04
Next, provide information about the healthcare provider or facility where the specimen was collected, such as the name, address, and contact information.
05
Describe the reason for the delay in submitting the specimen and provide any supporting documentation or evidence if required.
06
Follow any additional instructions provided on the form, such as signing and dating the document.
07
Review the completed form for accuracy and make any necessary corrections before submitting it.
08
Submit the filled-out delayed specimens form to the designated department or contact at Maimonides Medical Center.
09
Keep a copy of the completed form for your records.
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Follow up with Maimonides Medical Center for any further instructions or updates regarding the delayed specimen.

Who needs delayed specimensmaimonides medical center?

01
Individuals or patients who have encountered delays in submitting specimens to Maimonides Medical Center may need to fill out the delayed specimens form.
02
This can include patients who have experienced transportation issues, logistical challenges, or other complications resulting in the delayed submission of a specimen.
03
Healthcare providers or facilities that work with Maimonides Medical Center and have encountered delays in submitting specimens may also need to fill out this form.
04
The form helps ensure accurate record-keeping and proper handling of delayed specimens, allowing for appropriate analysis and diagnosis.
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Delayed specimens at Maimonides Medical Center refer to biological samples that have not been processed within the standard time frame due to various reasons, potentially affecting diagnosis and treatment.
Healthcare providers and medical professionals who collect and send biological specimens to Maimonides Medical Center must file reports for delayed specimens.
To fill out the delayed specimens form at Maimonides Medical Center, provide patient information, specimen details, reason for delay, and signature of the responsible healthcare provider.
The purpose of reporting delayed specimens is to ensure proper tracking of samples, maintain quality control, and address any potential impacts on patient care.
The report must include patient demographics, specimen type, collection date, date of delay, reason for delay, and the person responsible for the collection.
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