Section 181.06. Contents of report.

 

(1)   Information to accompany blood sample for laboratory analysis. Any health care provider who submits a human blood sample to a clinical laboratory for a determination of the lead concentration in the blood shall include all of the following information with the blood sample:

(a) The patient's first name, middle initial and last name.

(b) The patient's month, day and year of birth.

(c) The patient's gender, male or female.

(d) The patient's race: Z=Unknown, W=White, B=Black, A=Asian, N=Native American, O=Other.

(e) The patient's ethnicity: Z=unknown, H=Hispanic, N= Non-Hispanic.

(f) The patient's street address, apartment number, city or town, county and zip code.

(g) For a patient under 18 years of age, a parent's or guardian's first name, middle initial and last name.

(h) For a patient under 18 years of age, a parent's or guardian's area code and phone number.

(i) For a patient 16 years of age or older, and if the patient is employed, the employer's name, street address, city or town, state and zip code.

(j) For a patient 16 years of age or older, the patient's occupation, if employed.

(k) The patient's medical assistance number, if applicable.

(L) The month, date and year the blood sample was collected.

(m) The method of blood sample collection, venous or capillary.

(n) The name of the health care provider submitting the blood sample, the name of that person's facility or practice, street address, city or town, state, zip code, area code and phone number.

(o) The name and address of the patient's physician, if other than the health care provider.

(2)   Additional information to be provided by laboratory. A clinical laboratory that determines the lead concentration in a sample of blood submitted to it for a blood lead test shall submit to the department a report on the results of the blood lead test in accordance with ss. DHS 181.05 and 181.07 . That report shall include all the information in sub. (1) and, in addition, all of the following information:

(a) The name of the clinical laboratory performing the analysis, and the laboratory's street address, city or town, state, zip code, area code and phone number and clinical laboratory improvement amendments number.

(b) The month, date and year the laboratory analysis was completed.

(c) Results of the blood lead test in micrograms of lead per 100 milliliters of blood.

(3)   Failure to include information. Failure to include in the report on blood lead results all of the information required under subs. (1) and (2) is a violation of this chapter and therefore the person responsible is subject to prosecution under s. DHS 181.08 .

Cr. Register, May, 2000, No. 533 , eff. 6-1-00.

Note

A street address must be provided if available. A post office box is not an acceptable alternative. Microsoft Windows NT 6.1.7601 Service Pack 1