Contact Us - National Jewish Health 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out the 'Patient Information' section. Enter the patient's name, select their gender, and provide their date of birth along with the medical record number.
3. Proceed to the 'Billing Information' section. This is for institutional billing only; ensure you have all necessary details ready.
4. In the 'Report Delivery Information' section, input the account name, address, city, state, and zip code. If a duplicate report is requested, check the appropriate box.
5. Complete the 'Specimen Information' section by selecting whether it's a raw specimen or culture medium and providing submitter details including phone and fax numbers.
6. Fill out the 'Specimen Source' by selecting from various options such as blood or urine. Ensure to specify any other sources if applicable.
7. Continue through sections for bacterial cultures, fungal cultures, direct exams, rapid SA/MRSA testing, and any special instructions as needed.

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