Get Sc Dhec 4092 2020-2025

The SC DHEC 4092 is an Authorized User and Confidentiality Agreement form required for accessing the Laboratory Information Management System (LIMS) of the South Carolina Department of Health and Environmental Control. This guide will provide you with clear and comprehensive steps to fill out the form online, ensuring you provide all necessary information accurately and securely.

Follow the steps to complete the SC DHEC 4092 online.

1. Click the ‘Get Form’ button to obtain the SC DHEC 4092 form and open it in the online editor.
2. Begin filling out your personal information in the designated fields, ensuring your signature and date are included.
3. Provide your printed name, including your first name, middle initial, and last name as required on the form.
4. Indicate your professional designation, such as MD, DO, or RN, as applicable.
5. Fill in your license number, ensuring it is accurate and complete.
6. Enter the printed name of your practice or employer as requested.
7. Include both your business street address and mailing address.
8. If you are a previous LIMS user, select 'Yes' or 'No' and if 'Yes', provide the associated practice name.
9. Enter your email address, ensuring it is not a group or personal email address.
10. Once all fields are completed, review your information to ensure accuracy, then save your changes.
11. You can now download, print, or share the finished form as needed.

Complete your SC DHEC 4092 form online today to ensure your access to the LIMS.