G-1B Form SEP 2016 FINAL - SAMPLE.doc - dshs texas-2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by filling out Section 1, SUBMITTER INFORMATION. Ensure all required fields marked with double asterisks (**) are completed, including Submitter/TPI Number, Submitter Name, and Address.
  3. Proceed to Section 2, PATIENT INFORMATION. Enter the patient's last name, first name, date of birth (DOB), and other identifiers. Remember that the patient’s name on the specimen must match this form.
  4. In Section 3, SPECIMEN TYPE, indicate the type of specimen being submitted. This is crucial for accurate processing.
  5. Complete Sections 4 through 10 as applicable. Mark tests requested clearly and ensure any corrections are noted properly.
  6. Finally, review all sections for accuracy before saving your changes. Use our platform's features to sign and distribute the completed form easily.

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