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Request Tests

If you are unable to request tests electronically and need to send a specimen immediately, complete the paper or PDF Infectious Diseases Requisition Form:

  1. Enter the full name, date of birth, and county of the patient. If available, include the submitter’s reference number.
  2. Fill in the submitting laboratory’s name, address, laboratory permitted facility identification (PFI) number, contact person, and phone number.
  3. Record the specimen collection date, time (if applicable), and source/specimen type.
  4. Exposure, relevant travel, suspected organism, and all known clinical information should also be completed.
  5. Place the IDR in the pocket of the transport bag when shipping the specimen. If a specimen is sent without an IDR, testing will not be completed until the required information becomes available to the Wadsworth Center.