1628 2013-2025 Form

What is the 1628 form?

The 1628 form, also known as the DH1628, is a document used primarily in Florida for HIV testing purposes. It serves as a formal request for testing and provides essential information regarding the individual's consent and understanding of the testing process. This form is crucial for ensuring that individuals are informed about the implications of HIV testing and the confidentiality of their results.

How to use the 1628 form

To effectively use the 1628 form, individuals should first ensure they have the latest version of the document. The form must be filled out completely, providing accurate personal information and any required medical history. After completing the form, it should be submitted to the designated testing facility, either electronically or in person, depending on the facility's guidelines. It is important to retain a copy of the completed form for personal records.

Steps to complete the 1628 form

Completing the 1628 form involves several key steps:

1. Obtain the latest version of the 1628 form from a trusted source.
2. Fill in your personal details, including name, address, and contact information.
3. Provide any necessary medical history or information related to the testing.
4. Review the consent section carefully to understand your rights and the testing process.
5. Sign and date the form to indicate your consent for testing.
6. Submit the completed form to the testing facility as instructed.

Legal use of the 1628 form

The 1628 form is legally binding when completed correctly, provided that it adheres to the relevant laws and regulations regarding informed consent and confidentiality. It is essential that the form is filled out voluntarily, and individuals must understand their rights regarding the testing process. Compliance with state and federal regulations ensures that the information provided is protected and used appropriately.

Key elements of the 1628 form

Several key elements are included in the 1628 form to ensure clarity and compliance:

• Personal Information: This section requires the individual's name, address, and contact details.
• Medical History: Relevant medical information that may impact the testing process.
• Consent Statement: A clear statement indicating that the individual understands the testing process and consents to it.
• Signature: The individual's signature is required to validate the form.
• Date: The date of signing is crucial for record-keeping purposes.

Form Submission Methods

The 1628 form can be submitted through various methods, depending on the testing facility's requirements. Common submission methods include:

• Online Submission: Many facilities allow for electronic submission, where the completed form can be uploaded directly to their system.
• In-Person Submission: Individuals can bring the completed form to the testing site during their appointment.
• Mail Submission: Some facilities may accept forms sent via postal mail, though this method may require additional time for processing.