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    Laboratory Services Section
    MC 1947
    PO Box 149347 Austin, TX 78714-9347
    1100 W. 49th Street
    Austin, TX 78756-3199

    Phone: (512) 776-7318
    Fax: (512) 776-7294

    Phone Us Toll Free at:
    (888) 963-7111, ext. 7318

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Letter - M-47 Specimen Submission Form


State of Texas Seal



1100 W. 49th 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




October 26, 2011

RE: M-47 Specimen Submission Form

Dear Submitter,

The Laboratory Services Section has recently completed a review of all Laboratory Specimen Submission Forms as recommended by a recent State Audit. As a result of this review, forms were revised or deleted: to standardize the various forms in use within the DSHS Laboratory system; to ensure that all the information necessary to appropriately bill for the laboratory testing services is obtained; and to eliminate forms for testing that is no longer performed by the Laboratory Services Section.

Enclosed you will find a master copy of the revised M-47 Specimen Submission form and instructions for the tests usually requested by your facility and sent to the Women’s Health Laboratory (WHL). Please verify that the submitter information on the form is correct.

  • If the information is correct, please discard all previous versions of the M-47 Specimen Submission forms you may have on hand and begin using the revised forms immediately. Submitting specimens with previous versions of the forms may cause delays in testing and may result in billing errors.

  • If the information is not correct, please fax a corrected copy of the enclosed form to (210) 531-4506. This will allow us to make the necessary corrections.

If you have questions and/or comments, please contact Susan Hoffpauir at 1-888-963-7111 ext 6030. Thank you for your cooperation in this matter.


Grace Kubin, Ph.D.

Director, Laboratory Services Section

Last updated October 30, 2012