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Molecular Diagnostic Laboratory 1600 Rockland Road, Wilmington, DE 19803 302.651.6775 email: MDL memoirs.org Facsimile Verification Form Name of Facility receiving Fax: Name of Physician/Lab receiving
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Who needs a facsimile verification form?

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Individuals applying for specific services or transactions that require formal verification of documents or information.
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Remember, the specific individuals or organizations that require a facsimile verification form may vary depending on the purpose and context of its use.
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The facsimile verification form is a document used to verify the authenticity of a signature or document transmitted via facsimile machine.
Anyone who needs to verify the authenticity of a signature or document transmitted via facsimile machine may be required to file a facsimile verification form.
To fill out a facsimile verification form, simply provide the required information about the document or signature being verified, along with contact information for the verifying party.
The purpose of the facsimile verification form is to provide a method for verifying the authenticity of documents or signatures transmitted via facsimile machine.
On a facsimile verification form, you must report details about the document or signature being verified, as well as information about the verifying party.
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