nail sample collection method 2 methods: …. use our online "schedule a pick up" page....

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Correct collection process is vital to receiving the most accurate NGS diagnostic results. Please follow the steps below. back JOHN DOE INSURANCE front NAME(First/Last) DOB SS # / Patient ID: Specimen Date LAB REQUEST FORM NAIL SAMPLE COLLECTION METHOD 2 Methods: Clip & Scrape 5 6 DO - Collect nails from infected areas. DO - Rinse nail clippers with saline prior to cutting, if the nail clippers are kept in cold sterile container. DO NOT - Collect sample until nail beds have been wiped with Alcohol wipes. DO NOT - Collect sample with Clipper with out first rinsing with saline. Cold Sterile solution is a biocide and could degrade the microbial DNA in the nail sample. DO NOT - Touch the nail samples with hands. Do’s & Dont’s If nail clippers are kept in cold sterile container, rinse with saline prior to cutting. Skip this step if using autoclaved clippers. Clean nails with alcohol wipes. Clip infected nails. Add all nails to small collection bag or 2ml vial and seal tightly. Use blade to scrape the top nail bed to collect shavings. Clean nails with alcohol wipes. Add all shavings to small collection bag or 2ml vial and seal tightly. a. Write the patient’s name and collection date on the label found on the lab requisition form and paste it on the small collection bag or vial. If there is no label use a permanent marker to write name and collection date on small collection bag or vial. b. For private insurance plans please have the patient sign the lab requisition form excepting financial responsibility Submit patient face sheet and demographics with insurance information or both sides of a patient’s insurance card. 1 3 4 2 1 3 2 SEE SHIPPING INSTRUCTIONS NEXT CLIP NAILS SCRAPE NAILS 1-855-208-0019 | [email protected] | microgendx.com SOUTHWEST REGIONAL PCR LABORATORY, DBA MICROGEN DIAGNOSTICS, LLC

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Correct collection process is vital to receiving the most accurate NGS diagnostic results. Please follow the steps below.

back

JOHN DOE

INSURANCE

front

NA

ME(

Firs

t/La

st)

DO

B

SS #

/ P

atie

nt ID

:

Spec

imen

Dat

e

LAB REQUEST FORM

NAME(First/Last)

DOB

SS # / Patient ID:

Specimen Date

NAILSAMPLE COLLECTION METHOD2 Methods: Clip & Scrape

5

6

DO - Collect nails from infected areas.

DO - Rinse nail clippers with saline prior to cutting, if the nail clippers are kept in cold sterile container.

DO NOT - Collect sample until nail beds have been wiped with Alcohol wipes.

DO NOT - Collect sample with Clipper with out first rinsing with saline. Cold Sterile solution is a biocide and could degrade the microbial DNA in the nail sample.

DO NOT - Touch the nail samples with hands.

Do’s & Dont’s

If nail clippers are kept in cold sterile container, rinse with saline prior to cutting. Skip this step if using autoclaved clippers.

Clean nails with alcohol wipes.

Clip infected nails.

Add all nails to small collection bagor 2ml vial and seal tightly.

Use blade to scrape the top nail bed to collect shavings.

Clean nails with alcohol wipes.

Add all shavings to small collection bagor 2ml vial and seal tightly.

a. Write the patient’s name and collection date on the label found on the lab requisition form and paste it on the small collection bag or vial. If there is no label use a permanent marker to write name and collection date on small collection bag or vial.

b. For private insurance plans please have the patient sign the lab requisition form excepting financial responsibility

Submit patient face sheet and demographics with insurance information or both sides of a patient’s insurance card.

1

3

4

2

1

3

2

SEE SHIPPING INSTRUCTIONS NEXT

CLIP NAILS SCRAPE NAILS

1-855-208-0019 | [email protected] | microgendx.comSOUTHWEST REGIONAL PCR LABORATORY, DBA MICROGEN DIAGNOSTICS, LLC

PACKAGING & SHIPPINGCOLLECTION SAMPLES

PACKING SAMPLES FOR SHIPMENT

1. Drop into FedEx Dropbox / including Kinkos FedEx locations

2. Call for pick up 1-800-GoFedEx (1-800-463-3339) say "agent" twice to speak to agent. Let them know it's prepaid pick up.

3. Use our online "schedule a pick up" page.

When possible retain your tracking number.

3 CONVENIENT OVERNIGHT SHIPPING METHODS STANDARD SHIPPING

LAB REQUEST FORM

NAME(First/Last) John Doe

DOB 1/1/1965

SS # / Patient ID: 123-45-6789Specimen Date 1/1/2017

Signature:

John Doe

Lab Req in Rear Pocket

Sample in Front Pocket

1. Place the Small Sample Collection Bag and/or Vials into the front pocket (between the black hash-lines) of Biohazard Lab Bag

2. Place folded Lab Requisition Form, into the back pocket of the Lab Bag

3. IMPORTANT: Place only one Sample and one Lab Requisition in each Lab Bag

4. Peel white strip off Lab Bag to expose adhesive backing and, following instructions printed on Bag, create a continuous, airtight seal

5. Place the sealed Lab Bag into the Prepaid FedEx Shipping Box*

IF YOU DO NOTREQUIRE LAB RESULTSWITHIN 7 DAYS, PLEASEUSE SELF ADDRESSEDUS POSTAL ENVELOPE.

*NOTE: Please place multiple Lab Bagsin Shipping Envelope or Shipping Box.

1-855-208-0019 | [email protected] | microgendx.comSOUTHWEST REGIONAL PCR LABORATORY, DBA MICROGEN DIAGNOSTICS, LLC