Get the free INFLUENZA SAMPLE SUBMISSION FORM - doh sd
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South Dakota Public Health Laboratory 615 E. Fourth Street Pierre, SD 57501 Phone: 6057733368 Fax: 6057738201 doh.sd.gov/LabLAB USE ONLYINFLUENZA SAMPLE SUBMISSION FORM used for sample submission
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How to fill out influenza sample submission form
How to fill out influenza sample submission form
01
Obtain the influenza sample submission form from the designated source.
02
Fill out the patient information section with accurate details including name, date of birth, and contact information.
03
Provide details of the symptoms exhibited by the patient and the date of onset.
04
Specify any known exposure to influenza or recent travel history to affected areas.
05
Complete the healthcare provider information section with details of the ordering physician or healthcare facility.
06
Package the sample as per the instructions provided and submit the completed form along with the sample to the designated laboratory.
Who needs influenza sample submission form?
01
Healthcare providers
02
Individuals with suspected influenza symptoms
03
Laboratories conducting influenza testing
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What is influenza sample submission form?
The influenza sample submission form is a document used to submit samples of influenza virus for testing and analysis.
Who is required to file influenza sample submission form?
Healthcare providers, laboratories, and institutions that collect and test samples of influenza virus are required to file the influenza sample submission form.
How to fill out influenza sample submission form?
To fill out the influenza sample submission form, one must provide detailed information about the sample being submitted, including patient information, collection method, and testing procedures.
What is the purpose of influenza sample submission form?
The purpose of influenza sample submission form is to ensure proper documentation and tracking of influenza virus samples for research and diagnostic purposes.
What information must be reported on influenza sample submission form?
The information reported on influenza sample submission form includes patient demographics, sample collection details, testing methodology, and laboratory information.
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