LABORATORY TESTING LOG (Insert LHD Name) County Health Department Date: PATIENT INFORMATION cell Testing Information Preg Strep Strep Culture smear WM UA Glu culture HIV Hgb A1c Pap screen RPR FoB B CMP Titer NAAT Lead Protime TRUST ABO/Rh Hepatitis Varicella GC GC/Chlam Sickle Ab Gr Urine Stat Rapid Urine Date Test Performed Date Test Received Result Instructions Designate a staff member track and FU on labs. Place a patient label in the space in the first column. Record the date test was performed in the first row. Record date test received in the second row. Record result in the third row. Expand the table to fit agency needs.
LABORATORY TESTING LOG (Insert LHD Name) County Health Department Date: PATIENT INFORMATION Hgb UA Urine Preg WM Glu Rapid Strep RPR Stat smear GC culture A1c FoB Pap GC/Chlam NAAT Urine Culture Lead HIV CMP Protime Hepatitis Sickle cell ABO/Rh Ab screen Gr B Strep Varicella Titer TRUST Testing Information Date Test Performed Date Test Received Result Instructions Designate a staff member track and FU on labs. Place a patient label in the space in the first column. Record the date test was performed in the first row. Record date test received in the second row. Record result in the third row. Expand the table to fit agency needs.