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SPECIMEN BARCODE# 30244011 FORM 1 SYMPLECTIC #45D0660644This Space for DSS Laboratory Use OnlyPlease complete a separate form
for each specimen submittedQuestions? LabInfo@dshs.texas.gov
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Individuals applying for assistance or services from the Department of Social and Health Services (dshs) may need to fill out this space.
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What is this space for dshs?
This space is designated for the Department of Social and Health Services (DSHS) to collect specific information related to social services and health programs.
Who is required to file this space for dshs?
Individuals or organizations receiving services from DSHS or those who are mandated to report specific data as part of DSHS programs are required to file this space.
How to fill out this space for dshs?
To fill out this space, provide accurate and complete information as requested, following any specific guidelines or instructions provided by DSHS.
What is the purpose of this space for dshs?
The purpose of this space is to ensure that DSHS can gather vital information necessary for tracking services, compliance, and program effectiveness.
What information must be reported on this space for dshs?
The information that must be reported typically includes personal identification details, service utilization data, and any other relevant metrics as defined by DSHS.
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