Get Formulaire De Demande Analyses De Cheveux - Centre ... - Curml

This guide provides clear, step-by-step instructions on how to accurately complete the Formulaire De Demande Analyses De Cheveux online. It is designed to support users at every stage of the process, ensuring a smooth submission experience.

Follow the steps to successfully complete the online form.

1. Press the ‘Get Form’ button to access the form and open it in your browser.
2. Fill in the personal data for the patient. Include the patient's last name, first name, and complete address including postal code and location.
3. Indicate the date of birth for the patient to help identify the individual accurately.
4. Provide details regarding hair sample collection, specifying the payment amount in Swiss Francs and describing the sample type (e.g., back vertex hair). Include the hair length in centimeters.
5. Answer the health questions concerning any diseases the patient may have or may have had. Specify if the patient suffers from liver diseases or any other conditions.
6. Fill in information for laboratory analysis interpretation, indicating the patient's consumption of alcohol, drugs, or non-prescribed medications in the specified periods.
7. If hair samples are taken, provide details about any cosmetic treatments like bleaching or coloring.
8. Add any additional comments or notes that may be relevant to the analysis.
9. List the specific tests to be conducted by the laboratory, including options like EtG, amphetamines, cocaine, THC, opiates/opioids, and benzodiazepines.
10. Finally, record the location, date, and time of the sample collection, and ensure to document the receipt date at the CURML.

Encourage others to complete their forms online for a streamlined experience.