Laboratory Testing Services Manual - Forms and Laboratory Fee Schedule
Forms
Fees
If you have trouble viewing any of the documents below, please contact the HHS Accessibility Office, at Accessibility@hhsc.state.tx.us.
Order Forms for Laboratory Mailing Containers and Supplies
Phone: 512-76-7661
Fax: 512-776-7672
Some of these forms are in PDF format. See the file viewing information. Supplies are provided only for testing performed at the DSHS Laboratory.
Order Forms for Laboratory Mailing Containers and Supplies
Form # |
Name |
|
G-6A |
Order Form for General Supplies Revised: 01/2021 |
|
G-6C |
Order Form for Gonorrhea/Chlamydia (GC/CT) Laboratory Supplies Revised: 09/2019 |
|
G-399 |
Order Form for Child Health Laboratory Supplies Revised: 08/2018 |
|
G-6D |
Order Form for Newborn Screening Supplies Revised: 01/2022 |
|
G-6E |
Order Form for PKU Monitoring Supplies |
|
G-6F |
Order Form for TB Supplies Revised: 01/2021 |
Submitter Account Request Forms
Phone No. 512-776-7578
FAX No. 512-776-7533
Note: Unless otherwise noted, these are sample forms only. To receive specimen submission forms with your submitter identification, please request forms by email or by phone. If you do not yet have a submitter identification number, please complete and submit the Submitter Identification (ID) Number Request Form.
When printing out the sample forms below, you may notice that some of the section headings in white type do not print correctly. In that case, choose File > Print from your browser menu, then in the Print dialog box, check the option that says, "Print as image." This option is located directly underneath the "Properties" button. Then click the "Ok" button. The sample form should then print normally.
Test Request Form Samples and Master Forms
Obtaining Specimen Submission Forms by Email
Email request to Laboratory Forms. Please provide the required information below when requesting forms by email.
Required Information |
G-2A or G-2B Microbiology Submission Forms
G-1B Specimen Submission Form and G-THSTEPS Specimen Submission Form
|