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Request for Testing Service Forms

Filling out a Form

Most samples or specimens submitted to the laboratory for testing require that a completed Request for Analytical Services form be sent with each individual specimen.

 

Test request forms with pre-populated customer address information can be ordered singly or along with testing supplies by clicking the "Order from the Lab" link to the left, and then clicking the relevant supply ordering link.

 

 

Form Number Important Notes
250-A

Used for the general public when submitting water samples for testing. Order special collection bottles

250-B Used for the water suppliers when submitting water samples for testing. Order special collection bottles
270-71 Public health testing (with patient history), used for all patient testing, including used by the Infertility Prevention Program IPP CT/GC testing. Available to county health, epidemiologists and healthcare only.
272 Bird and animal testing.Available to county health, epidemiologists, healthcare and veterinarians only.
273 Insect and mosquito testing. Available to county health only.
Newborn Screening Available to hospitals, birthing centers, midwives and pediatrician's offices only.
Toxicology Available to law enforcement agencies only.