Updated Test Request Form: Required Laboratory Data Reporting
- Patient race
- Patient ethnicity
- Patient gender
- Employed in healthcare Yes/No/Unknown *NEW
- Symptomatic as defined by CDC? Yes/No/Unknown *NEW
- Date of Symptom Onset (if symptomatic) mm/dd/yyyy *NEW
- Hospitalized at time of COVID test? Yes/No/Unknown *NEW
- ICU? Yes/No/Unknown *NEW
- Resident in a congregate care setting Yes/No/Unknown *NEW
- Pregnant? Pregnant/Not Pregnant/Unknown *NEW
- Patient residence county *NEW
- Date test ordered mm/dd/yyyy *NEW
HHS hopes that these data will contribute to understanding disease incidence and trends: initiating epidemiologic case investigations, assisting with contact tracing, assessing availability and use of testing resources, and identifying supply chain issues for reagents and other material. The State Hygienic Laboratory at The University of Iowa is coordinating this change with the Iowa Department of Public Health.
An additional question will provide SHL with another piece of important information:
- Antigen confirmation 1st test/2nd test *NEW
The sample Collected Time has been removed from the electronic and paper test request forms as it is not critical to COVID testing.
If this information is not available to the lab, do not delay the transport of the sample.
Remember to use SHL’s COVID-19 Electronic Test Request Form to improve the turnaround time of the results. Detailed instructions on its use are located in the last section of the OpenELIS Web Portal User Guide.
Together, we will continue to assure a rapid and thorough public health response to the COVID-19 pandemic.
Thank you for your work.
