Forms

These forms are for ordering tests and supplies from the Public Health Laboratories. Download the forms in PDF, and then fill them out following instructions.

Serology, Virology and HIV

• COVID19 Sample Submission (PDF)
• Serology/Virology/HIV Form (PDF)
• Public Health Laboratories Specimen Shipping Tips (PDF)

Bioterrorism

• Bioterrorism Specimen Submission Form (PDF)

Environmental Samples

• PHL Biothreat Environmental Sample Submission Chain Of Custody Form (PDF)

Influenza

• Influenza Testing at Public Health Laboratories (PDF)
• Serology/Virology/HIV Form (PDF)

Microbiology

• Food and Food Related Bacteriology Form (PDF)
• Microbiology Form (PDF)

Microbiology Form is also used for Molecular Diagnosis/PCR. Please indicate Molecular Diagnosis/PCR on the form.

Includes: Campylobacter spp., E. coli, Shigella spp., and Yersina spp., Bordetella pertussis, Corynebacterium diphtheria, Beta Streptococcus, and Group A Streptococcus.

Order Supplies

• Laboratory Supply Order Form (PDF)

Rabies

• Guidelines for the Submission of Specimens for Rabies Testing (PDF)
• Laboratory Report and Animal History Rabies Form (PDF)
• Rabies Packaging Procedure (PDF)
• Rabies Resources for Public Health

Serology

• Serology/Virology/HIV Form (PDF)

Includes: Measles, Rubella, SARS (Severe Acute Respiratory Syndrome), and West Nile and SLE (St. Louis Encephalitis), HIV (Human Immunodeficiency Virus) and syphilis.

Tuberculosis

• Mycobacterium Isolates Form (PDF)
• Sputum Collection Instructions (PDF)