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Clinical Genomics Requisition Form Please complete every field and tick box clearly. PATIENT INFORMATIONPATIENT SAMPLE INFORMATION SAMPLE TYPE: Collection Date:___ MM/DD/YY Saliva Swab Was this sample

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How to fill out was this sample collected

01

Gather all necessary information about the sample being collected.

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Ensure that proper collection materials are available, such as containers and labels.

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Follow the specific instructions for collecting the sample as provided by the testing facility or organization.

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Seal the sample container properly and label it clearly with the necessary information.

Who needs was this sample collected?

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Individuals who are required to provide a sample for testing purposes.

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Healthcare professionals who are collecting samples for diagnostic purposes.

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Researchers who are conducting studies that require sample collection.

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What is was this sample collected?

This sample was collected to assess compliance with regulatory requirements or to gather data for analysis.

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Individuals or entities that are subject to the regulations governing the sample collection are required to file.

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The purpose of collecting this sample is to ensure adherence to standards and to monitor performance or outcomes.

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The report must include details such as identification of the sample, collection date, and any relevant measurements.

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