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.

Virology and Serology

• COVID19 Sample Submission (PDF)
• Public Health Laboratories Specimen Shipping Tips (PDF)
• Virology Requisition Form

Bioterrorism

• Bioterrorism Specimen Submission Form (PDF)

Environmental Samples

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

Influenza

• Influenza Surveillance Lab Form
• Virology and Serology Requisition Form
• Influenza Testing at Public Health Laboratories (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.

Sexually Transmitted Infections

• Sexually Transmitted Infection Requisition Form

Order Supplies

• Laboratory Supply Order Form (PDF)

Rabies

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

Tuberculosis

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