Get Michigan Department Of Community Health Bureau Of Laboratories Microbiology/virology Test

Filling out the MICHIGAN DEPARTMENT OF COMMUNITY HEALTH BUREAU OF LABORATORIES MICROBIOLOGY/VIROLOGY TEST form is essential for accurate laboratory testing. This guide provides detailed instructions to help users complete the form correctly and efficiently.

Follow the steps to accurately complete the form.

1. Press the ‘Get Form’ button to access the document and open it in your editing interface.
2. Provide your agency or submitter information. Enter the Starlims agency code and the contact phone number, ensuring that it is a 24/7 number if necessary.
3. Fill in the physician of record or legally authorized person ordering the test along with their National Provider Identifier.
4. Complete the patient information section. Ensure the name matches the specimen label exactly. Include the submitter’s patient number, city of residence, zip code, gender, race, and ethnicity, as well as the date of birth.
5. In the subscriber information section, indicate the subscriber number and select the applicable options for Medicaid, ADAP, or other categories.
6. Enter the date and time the specimen was collected, ensuring to mark AM or PM accordingly.
7. Indicate the test requested by checking the relevant options. Ensure you also specify the specimen source from the provided list to ensure accuracy.
8. If applicable, fill in additional details for specific tests, including indicating test reasons and any relevant dates related to conditions such as rabies or syphilis.
9. Review all entries for accuracy. Once complete, save your changes, download the form, print it, or share it as required.

Complete the MICHIGAN DEPARTMENT OF COMMUNITY HEALTH BUREAU OF LABORATORIES MICROBIOLOGY/VIROLOGY TEST form online today for efficient results.