Revised G-1B, G-2A, G-2B, and new G-THSTEPS Specimen Submission Forms

060110 Revised G-1B, G-2A, G-2B, and new G-THSTEPS Speciemn Submission Forms

State of Texas Seal

TEXAS DEPARTMENT OF STATE HEALTH SERVICES

DAVID L. LAKEY, M.D.
COMMISSIONER

1100 W. 49^th Street • Austin, Texas 78756
P.O. Box 149347 • Austin, TX 78714-9347
1-888-963-7111 • http://www.dshs.state.tx.us
TDD: 1-800-735-2989

June 1, 2010

Dear Submitter,

RE: Revised G-1B, G-2A, G-2B, and new G-THSTEPS Specimen Submission Forms

Effective June 2010, the Texas Department of State Health Services (DSHS) Laboratory Services Section will be changing the G-1B, G-2A, and G-2B specimen submission forms. In addition, a new G-THSTEPS specimen submission form has been created for submitting all Texas Health Steps (THSTEPS) specimens.

Enclosed you will find a new master copy of the new Specimen Submission forms and a copy of the form’s instructions. The forms will be mailed in two envelopes: one with G-2A and G-2B forms and the other with G-1B and G-THSTEPS forms. Please verify that your submitter information on the Specimen Submission forms is correct and up-to-date. If it is not, please complete the enclosed form titled “Submitter Identification (ID) Number Request Form” (Form #F14-13277) and fax it to (512) 458-7533.

Discard all old DSHS Laboratory specimen submission forms that are listed below:

OLD FORM	Comments
G-1B (SEP 2008) Rev 8	- Replaced with G-1B (JUN 2010) Rev 9 (PDF 165kb)
G-2A (SEP 2008) Rev 2	- Replaced with G-2A (JUN 2010) Rev 3 (PDF 192kb)
G-2B (SEP 2008) Rev 2	- Replaced with G-2B (JUN 2010) Rev 3 (PDF 164kb)

The new specimen submission forms are:

NEW FORM	Comments
G-1B (JUN 2010) Rev 9 (PDF 165kb)	- for Clinical Chemistry and Newborn Reference/DNA specimens
G-2A (JUN 2010) Rev 3 (PDF 192kb)	- for Serology and Virology specimens
G-2B (JUN 2010) Rev 3 (PDF 164kb)	- for Bacteriology and Parasitology specimens
G-THSTEPS (JUN 2010) (PDF 169kb)	- for Texas Health Steps specimens

If you have any other questions and/or comments, please contact Susan Hoffpauir at 1-888-963-7111 ext. 6030. Thank you for your continued support.

Sincerely,

Susan U. Neill, PhD, MBA
Director, Laboratory Services Section