Filling out the Client Authorization Form

This is a quick instruction on how to fill out the Client Authorization Form for LabCorp.

1. Begin by making sure the Account information is correct, located at the top and left on the form.
2. Then fill out the Amount Collected at the top and right on the form. If you are not including any payments with this form, write N/A.
3. The “Account’s Case #” is the Genetic Testing Authorization Number from PESU.
4. “District/Court #” is the FGN. Please list the OAH or District Court Number if you do not have an FGN yet.
5. “Cause #” is the LabCorp number assigned in their system. We will not have this number if all parties are being tested at once. If the samples are being taken separately on different days, we may then receive that number from LabCorp.
6. You will then name the Mother (M), Child number one (C1), Alleged Father (AF), and Child number two (C2). Please list all parties even if not all are testing that day.
7. If there are already Specimens on file, please indicate that by placing an “X” in the appropriate location under “Specimen on File?” You will then list the Cause number from that case.
8. If you have any notes for the phlebotomists or LabCorp, please list them in the Special Instructions box. Ex. “Please use the AF’s sample from a previous case.”
9. Now fill out the information on each party. You must fill in all of the shaded areas. If they list other as their race, list what “other” means. On “ID # & Type” make sure to list the type of ID the party brings and the number associated. Ex. OK DL # V08xxxxxxx. If they do not bring proof of identification, proceed with testing since we have a picture and thumb prints.
10. The back side will include a photograph of the parties. The child(ren) and mother will be photographed together. The AF will ALWAYS be photographed alone. Also if the BP is not the party that brings the child, do not include that party in the child(ren)’s photo. Attach each photo in the designated areas. The parties will sign and date their photo.
11. Each party will date, print, and sign their name under the liability statement below their photos. The mother or guardian will sign for the child(ren), if they are under 18.
12. Each party will leave their thumbprint in the designated area below the liability statement.
13. You then will certify that you have collected the samples from the person(s) identified above by listing the address of the collection site, printing and signing your name, and dating the form in the box under the thumb prints of the parties.
14. If there is a witness, you will have them sign and date as well.
15. Below the collection location and the collector information, you will print, sign, and date as the person packaging the specimens.
16. This form is then included with the specimens collected to send to LabCorp.