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Department of Health Services

Public Health Regional Laboratory

Specimen Submission Forms

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Environmental Sample for Biological Threat Agent Testing Submission Form
For law enforcement use only.

Lyme Organism in Ticks (PDF: 191 kB)
Use this form to submit tick specimens for testing.

Title 17 Specimen Submission Form (PDF: 228 kB)
Use this form to submit all types of specimens.

Water Testing Lab Slip  (PDF: 146 kB)
Use this form for all water testing.

Multiple Water Samples Submission Form (PDF: 63 kB)

Shellfish Growing Waters Sample Submission Form (PDF: 95 kB)

Zika virus disease – Use these forms to submit Zika virus specimens.

Zika Virus Testing Criteria & Instructions Form (PDF: 161 kB)

Zika Virus Testing Criteria & Instructions Form-Mother Post Delivery (PDF: 519 kB)

Zika Virus Testing Criteria & Instructions Form-Infant Post Delivery (PDF: 158 kB)