UNITED MEDICAL LABORATORIES, INC.

7601 Lewinsville Rd. Suite 300, McLean, VA 22102

703-356-4422

URINE CULTURE, BROTH METHOD INSTRUCTION


Please include following information:


  1. Photo ID: (Driver’s License)

  2. Patient’s Name

  3. Date of Birth

  4. Address

  5. Telephone #

  6. E-mail address

  7. Where to forward the result to:

  8. Dr’s information (If applicable)

  9. Insurance information (copy of front and back of the card)- If applicable.

  10. Payment method:

  11. Even if patients have insurance, we still require patients to send payment of $129.00. (If shipping from outside the United States, please add $20.00 duty charge to your total.)

  12. It is not our obligation to file insurance for these tests. We will help the patient file the insurance claim if requested by the patient. If the insurance company pays for the service rendered, we will be sending a reimbursement back to the patient for the amount paid by the insurance company, but not more than the amount paid by the patient.


Collecting Urine Sample:

  1. Patient needs to get sterile urine container.

  2. Clean the genital area before collecting the sample.

  3. Catch midstream (More details on last page).

  4. Tightly seal and label (patient’s name) the container.

  5. Please put the urine container in zip-lock bag before packing them.

  6. Please mail the sample OVERNIGHT EXPRESS (UPS or Fedex) with either dry ice (frozen carbon dioxide) or an ice pack to keep the specimen refrigerated.


Collecting Semen Sample:

  1. Clean the genital area before collecting the sample.

  2. Collect sample in a sterilized container.

  1. Tightly seal and label (patient’s name) the container.

  2. Please put the urine container in zip-lock bag before packing them.

  3. Please mail the sample OVERNIGHT EXPRESS (UPS or Fedex) with either dry ice (frozen carbon dioxide) or an ice pack to keep the specimen refrigerated.


Cost of the test is $ 129.00 (includes urine broth culture and antibiotic sensitivity)

Yeast (Candida Albicans) is additional $96.00.


*** If you are taking antibiotics, you have to stop taking them for 2-3 days before collecting the urine sample. ***


If you have further questions, please contact us at number listed above.

Thank you for using our service.



FOR LAB USE ONLY


ID#:

Date:



UNITED MEDICAL LABORATORIES, INC.

7601 Lewinsville Rd. Suite 300, McLean, VA 22102

703-356-4422



PLEASE PRINT


Last Name First Name

Date of Birth

Address

Tel #

Fax #

E-mail: (For oversea patients)

Dr’s Name and Address (If applicable)

Tel #

Fax#

Please check following:


( ) Urine Broth Culture : $ 129.00


( ) Semen Broth Culture : $ 129.00


( ) Yeast (Candida Albican) : $ 96.00


( ) Chlamydia Trachomatis Culture: $ 168.00


( ) Ureaplasma/Microplasma: $ 89.00

* PATIENTS SHIPPING FROM OUTSIDE THE UNITED STATES, PLEASE ADD $20.00 DUTY CHARGE TO YOUR TOTAL.

Credit Card: VISA / MASTERCARD / DISCOVER

(circle one)

Number: __________________________ Exp. Date: ________

Name on Card: _______________________________________

Total Amount:

Signature:

Date:







TEN STEPS FOR OBTAINING CLEAN VOIDED MIDSTREAM

URINE SAMPLE FOR CULTURING



  1. THIS IS A MUST!: At the first morning voiding (or if otherwise, at about three (3) hours before you plan to take the clean voided specimen), do a “preparatory urination” by intermittently stopping and releasing the flow as many times as you can – in quick succession – until finished. This serves to flush essentially all colonizing bacteria from the urethra. If you are not sending the sample out by overnight express mail within an hour or so, you should refrigerate this sample with you then. It is best not to do your sample at a doctor’s office especially if all that is available is a paper cup and no apparent sterilized containers.


  1. During the three (3) hour interval, do not take in any other fluids which could dilute normal bladder accumulation. At the end of the three hours, shower or thoroughly cleanse the areas around the urinary exit (especially the perineal) with soap and water. Blot off with fresh clean tissue or dry area with low setting of hair dryer. At no time should your hands touch any part of the urinary exit area.


  1. Spread a clean tissue on a surface close to the toilet bowl.


  1. Remove the cap from the sterile specimen cup and place it, open side down on the tissue place the open cup next to it. Do not touch the rim of either the cup or cap with finders or body surface at any time.


  1. Sit on the seat backwards of the usual posture, i.e. straddle the seat with the legs and start the stream if this is comfortable for you. Otherwise, straddle standing forward.


  1. Permit a small quantity to spill into the bowl to the slow count of 4 or 5 (as you feel the possible volume allows); the longer, the better.


  1. Do not stop the stream, but while still flowing, present the open cup to collect a small amount (1-2 oz) direct from the urethral exit. The stream must not wash over adjacent skin surfaces.


  1. Do not stop the stream while collecting the specimen. After obtaining the small quantity, (cup no more than ¼ to 1/3 of the total sterile container), withdraw the cup and carefully replace its cap making sure still that you do not touch the inside of the rim.


  1. If you are on antibiotics, do a “preparatory urination” as in (1) above at the time of medication and then take the specimen to be sent in about three (3) hours later. Best to take sample in the morning (after bedtime dosage of antibiotic but before morning dose) if possible.


  1. IMPORTANT(ANOTHER MUST!): The above “preparatory urination” is also recommended for all other voidings as part of a therapy to improve bladder control and keep the urethra repeatedly flushed of colonizing bacteria. Periodic monitoring by broth culture for resistant bacteria (every one to two months) while on long-term antibiotics is recommended.