Emerging Disease Discovery Support for Diagnostic Fees
SHIC will support diagnostic fees for emerging disease discovery with approved cases. This form is to be completed by the diagnostician* after identifying a qualifying, undiagnosed case with due diligence (including notifications of possible FAD). It also serves as application for financial support for laboratory fees on behalf of the submitter**. All clinical and laboratory information can be submitted anonymously (without submitter** or other identifiers) will be kept confidential, and will not be shared without permission of the submitter**. A submitter** consent form will be signed and held by the Diagnostic Laboratory of record as part of the permanent case file.
After completing the form below, a panel of three diagnosticians from public institutions will review the information and contact the diagnostician* of record within 48 hours with a decision or request for additional information.
809 Wheeler Street, Suite 110-366 Ames, IA 50010 – USA