Get Wi H-445 - Milwaukee City 2019

The WI H-445 form is essential for submitting specimen requests to the Milwaukee Health Department Laboratory. This guide aims to provide a clear, step-by-step approach for users to complete the form online, ensuring all necessary information is accurately provided.

Follow the steps to successfully complete the WI H-445 form.

1. Press the ‘Get Form’ button to retrieve the form and open it in your chosen document editor.
2. Begin with the patient information section. Fill in the required fields such as first name, middle initial, date of birth, social security number, street address, city/state/zip, and phone number.
3. Indicate the race and ethnicity of the patient by checking the appropriate boxes provided.
4. In the specimen type section, check the appropriate specimen option and provide any additional information requested, including the last name, gender, and date collected.
5. Select the tests requested. Check all applicable options for bacteriology, parasitology, serology, molecular testing, and provide any necessary details for suspect agents or previous tests.
6. Complete the patient history/clinical info section by entering the clinical diagnosis, the date of onset for the condition, and, if relevant, the date of death.
7. Fill out the facility information where results will be returned. Include the facility name, physician's name, address, city/state/zip, phone, and fax.
8. In the other significant factors section, check any applicable risks associated with the patient’s health status.
9. Once all fields are completed, save the changes to your document. You can then download, print, or share the form as necessary.

Complete your documents online to ensure a smooth submission process.