Get Doh 3519f Form

The Doh 3519f Form is essential for laboratories in New York State seeking to request the deletion of FDA-approved tests from their test menu. This guide will help users navigate the form online, ensuring that all necessary information is accurately provided.

Follow the steps to complete the Doh 3519f Form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Fill in the laboratory PFI (Provider Facility Identifier) at the top of the form. This unique identifier is critical for processing your request.
3. Provide the name and address of the laboratory in the designated field. Make sure to include complete and accurate details.
4. For each test you wish to delete, enter the test name in the corresponding field. Make sure the name is descriptive enough for identification.
5. Select the appropriate permit category from the provided list. Familiarize yourself with the categories to ensure the correct choice.
6. Indicate the method used for the test, such as chemiluminescent immunometric assay or real-time PCR, ensuring it matches your laboratory’s process.
7. Specify the instrument used for detection, mentioning the type, brand, and model if applicable.
8. Include the kit name of the commercially available test, if applicable, ensuring clarity in what is being requested for deletion.
9. Indicate the specimen type for the test, for instance, blood or urine, to inform the context of the deletion.
10. Repeat steps 4 to 9 for each additional test you wish to delete.
11. Once all fields are completed, ensure the laboratory director signs the form. Remember, only original signatures are valid; no signature stamps will be accepted.
12. After completing the form, review all entries for accuracy and clarity. Save changes and download the completed form.
13. You can choose to print or share the form as needed, ensuring you comply with submission instructions.

Complete your documents online today to streamline your laboratory's request process.