FORMS AND information for providers
- Newborn Form
- Hemoglobinopatías (Formulario Pediatrico)
- Adult Form
- Hemoglobinopatías (Formulario para Adultos)
When submitting a blood specimen to us, please make sure to properly label the tube with patient name, date of birth (DOB) and date of collection (DOC). Following the Joint Commission National Patient Safety Goals, specimens should be labeled at the patient's site by the originating party. Unlabeled Sample Tubes received in our laboratory will not be processed. An unsatisfactory report with unlabeled specimen code will be issued and no testing will be performed in such specimen. A full report with results will be generated upon receipt of a properly labeled specimen.
Kindly, remember that the Sample Request Form (SRF) needs to be filled out completely, accurately and legibly. Incomplete forms or forms without return address will delay test results. Please download the SRF from the Meharry website: http://sicklecell.mmc.edu, where you can find the SRF in English and Spanish.
Our regular turn-around-time is 14 days, and it is calculated from the time the specimen is received in the laboratory to the time the results are mailed out to you. Specimens involving rare hemoglobin variants may require additional time for testing in order to properly identify the hemoglobinopathy involved. These specimens may have an extended turn-around-time depending on the complexity of the hemoglobin variants. You will receive a notification from us requesting additional time for testing or stating that the specimen is pending.
If you have any questions please contact us at 615-327-6763 or email us at email@example.com
Proper collection and handling of specimens are essential when sending samples to the Meharry Sickle Cell Center (MSCC). The procedure described below must be followed to assure safe transit and compliance with Occupational Safety Health Administration (OSHA) and CLIA 88 standards as well as postal regulations.
On a regular basis and also upon request, the MSCC mails to different Health Care Agencies in the State of Tennessee, all supplies needed for blood collection and mailing of blood specimens to the MSCC for the purpose of hemoglobinopathy testing.
If you need MSCC blood collection supplies, please contact us by either e-mail
firstname.lastname@example.org, fax 615.327.6008 or phone 615.327.6763 with your request as follows:
- Request Forms: Adult and Children
- Microvette Tube EDTA
- Plastic Bags
- Styrofoam Mailing Boxes
Please note that you can download the Hemoglobinopathy Testing Laboratory Request Form at the top of this page (forms are available in English and Spanish).
Blood Collection Procedure:
1. Label tube with patient's name, date of birth (DOB) and date of collection (DOC) (label not included). Unlabeled blood samples will not be processed by our laboratory. An unsatisfactory report with unlabeled specimen code 016, will be issued and no testing will be performed in such specimen. A full report with results will be generated only upon receipt of a properly labeled specimen.
2. Perform a finger or heel stick using good laboratory techniques following the instructions of the lancing device manufacturer (included).
3. Wipe off the first drop of blood and then touch the capillary tip of the Microvette Tube to the droplet of blood as it appears at the incision. Excessive pressure or squeezing on puncture area must be avoided to prevent premature coagulation in the capillary.
4. After the blood has been collected, the capillary unit is removed and properly discarded and the sample container is closed with the attached stopper.
5. Immediately mix the blood with the EDTA anticoagulant by inverting several times the collection tube back and forth.
6. Fill out the laboratory sample request form completely and legibly, obtain signatures and include the address where the results should be mailed. Fold laboratory request form and place it in unsealed pocket of the biohazard bag.
7. Place the properly capped microvette tube in the zip lock biohazard bag, seal it and place it in the styrofoam mailing box.
8. For individual and up to 3 specimens, please place them in small Styrofoam box
(provided) and cover with mailing sleeve (provided) and seal both ends. Please place return address and label the mailing box with "Exempt Human Specimen".
9. If you know or suspect that the patient specimen has an infectious agent (HIV, hepatitis, etc.), then you need to follow specific instructions for labelling, packaging and documentation of Packaging for Category B shipment of a biological substance from the Department of Transportation and the International Air Transit Authority. A UN 3373 label needs to be affixed to the mailing box for Category B shipments.
10. For community screenings where several samples will be mailed to the MSCC at a single time, please use a large Styrofoam box with outer cardboard box (not provided by us), and place inside the box, the individual biohazard bags containing single specimens with their respective SRFs.
11. Kindly, remember that the Sample Request Form (SRF) needs to be filled out
completely, accurately and legibly and needs to be signed. Incomplete forms or forms without return address will delay test results. Please download the SRF from the Meharry website.
If you have any questions please contact the Meharry Sickle Cell Center at 615-327-6763 or email us at email@example.com.
On a regular basis and also upon request, the center mails blood testing supplies to health care agencies in Tennessee. If you need blood collection supplies, please contact us by e-mail firstname.lastname@example.org, fax (615.327.6008), or phone (615.327.6763) with your request as follows:
Request Forms: Adult and Children
Microvette Tube EDTA
Styrofoam Mailing Boxes
Please note that you can download all forms using the links in the navigation menu above. (Forms in English and Spanish are available.)