Get Inappropriate Sample Identification Release Form

Filling out the Inappropriate Sample Identification Release Form accurately is essential for the proper management of patient samples in laboratory settings. This guide provides clear, step-by-step instructions to assist users in completing the form online.

Follow the steps to successfully fill out the form online.

1. Click ‘Get Form’ button to obtain the release form and open it in your preferred online editor.
2. Enter the type of error related to the sample. Choose from options such as 'No ID on sample' or 'Incorrect information on sample.' If applicable, specify any other error.
3. Complete the section for original information, providing details like the patient's name, unique identifier, specimen type, and contact information for the physician or director interaction.
4. Fill in the section for corrected information. Ensure that all necessary corrections are documented accurately, including the patient's name and unique identifier.
5. In the acknowledgment section, print your name and title, then sign and date the form to assume full responsibility for relabeling the patient sample and requisition form.
6. Complete the notification information for PSN documentation by entering the person's name contacted, location, date/time, technician ID, and how the issue was resolved (e.g., relabeled/corrected).
7. After thoroughly reviewing all sections for accuracy, save your changes. You can choose to download, print, or share the completed form as necessary.

Complete your Inappropriate Sample Identification Release Form online now to ensure proper sample management.