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F40TB Elimination Specimen Submission Form (Jan 2020) Rev.v.1***DSS LAB USE ONLY**CIA #45D0503753 CAP #2148801 https://www.dshs.texas.gov/lab/so_tx_lab.shtm P: (956) 3648746FAX: (956) 4128794Section

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How to fill out f40-tb elimination specimen submission

01

To fill out F40-TB elimination specimen submission, follow these steps:

02

Start by entering the date of submission in the designated field.

03

Provide the name and contact information of the healthcare facility or laboratory submitting the specimen.

04

Enter the patient's name, date of birth, and unique identification number, if applicable.

05

Specify the type of specimen being submitted, such as sputum, urine, or blood.

06

Indicate any relevant clinical information, such as symptoms exhibited by the patient or previous treatment history.

07

Provide the name and contact information of the healthcare provider responsible for the testing or diagnosis.

08

Include any additional documentation or forms required for submission.

09

Double-check all entries for accuracy and completeness before submitting the form.

10

Submit the completed F40-TB elimination specimen submission to the designated recipient or laboratory.

11

Keep a copy of the completed form and supporting documents for your records.

Who needs f40-tb elimination specimen submission?

01

F40-TB elimination specimen submission is required by healthcare facilities, laboratories, or healthcare providers who are involved in the testing and diagnosis of tuberculosis (TB) elimination.

02

It ensures the proper submission and documentation of specimens for TB testing, contributing to the overall efforts in eliminating TB.

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What is f40-tb elimination specimen submission?

F40-TB elimination specimen submission is a form used to report tuberculosis specimen submission for elimination purposes.

Who is required to file f40-tb elimination specimen submission?

Healthcare facilities and laboratories are required to file f40-TB elimination specimen submission.

How to fill out f40-tb elimination specimen submission?

F40-TB elimination specimen submission should be filled out with details of the tuberculosis specimen being submitted, along with relevant information about the patient and laboratory.

What is the purpose of f40-tb elimination specimen submission?

The purpose of f40-TB elimination specimen submission is to track and monitor tuberculosis cases for elimination efforts.

What information must be reported on f40-tb elimination specimen submission?

Information such as patient demographics, specimen details, laboratory test results, and healthcare provider information must be reported on f40-TB elimination specimen submission.

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