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It supports additions and deletions of complete program modules, specifies timing requirements (at least four weeks before ship date), and instructs users to use the test menu deletion form when analytes are no longer tested. 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\nSignature:                                    \nPrint Name:                                          \nDate:                        \nFax this form to 1-202-835-0440  \nNEW Billing Address-Address where the invoice will be sent  \nNEW CLIA Number:D  \nor email it to:mle@aab-m|e.org  \nPhone:  \n# Program Module\\#Additions:\n\nPlease Do NOT Send Form Unless You Have Changes.ONLY fill in the fields that changed.  \nChoose Event(s)□M1  \nNEW Shippina Address-Address where the kits will be shipped (This address mav NOT be a PO Box)  \nContact/Facility Name:                                   \nAddress:                                      \n                Fax:                       \nEmail:                                         \nContact/Facility Name:                                \nAddress:                                      \nPhone:                Fax:                       \nEmail:                                       \nNEW Laboratory Director:                                              \nOrder Changes-List any program module \\#s that you wish to add to-or delete from-your order.List ONLY complete program module additions or deletions.Do NOT list analytes.Order changes mustbe received at least four weeks before the corresponding ship date to avoid extra charges and fees.  \n# Program Module\\#Deletions:\n\n\n| Please report any individual analytes your laboratory is no longer testing by faxing or emailing the  \u003Cbr>Test Menu Deletion Form.It is not necessary to send both this form and the test menu deletion form;  \u003Cbr>we willadjust your test menu based upon your order changes.In most cases,deleting an analyte  \u003Cbr>from your test menu will not affect your program module order.  \u003Cbr>Questions?Call AAB-MLE Customer Service at 1-800-234-5315,or email:mle@aab-mle.org   |\n| --- |\n\nRegulatory Agencies □ADD □DELETEID\\#Assigned By Agency              \nAdditional Copies □ADD □DELETEName:                   Address:                     Ph         Fax         Fmail                   \n□The person named above is a consultant  \nPlease send me  \nan updated  \nOrder Verification","cbCairOwJzMW2Xrr","https://ap.wps.com/l/cbCairOwJzMW2Xrr","pdf",427130,"English","# Change Request Instructions\n## Required Fields and Signature\n## Billing Updates and CLIA Number\n## Shipping Address and Contacts\n# Program Module Additions and Deletions\n## Additions\n## Deletions\n## Order Changes Timing and Requirements\n# Regulatory and Distribution Options","[{\"question\":\"When should order change requests be submitted to avoid extra charges?\",\"answer\":\"Order changes must be received at least four weeks before the corresponding ship date to avoid extra charges and fees.\"},{\"question\":\"What information is required for billing and account updates?\",\"answer\":\"The form requires the account/ID number, the fill-in year and event, signature, printed name, date, and new billing address and new CLIA number.\"},{\"question\":\"How should program module changes be reported?\",\"answer\":\"List only complete program module additions or deletions, not individual analytes, and use the provided additions/deletions sections for the module numbers.\"}]","Change-Request-Form-AAB-MLE - Billing and program module additions/deletions | PDF"]