Lab Request Forms

All forms needed to submit lab tests to the Alaska Public Health Laboratories

Overview

Submitters must complete a lab request form and include with each patient (or animal) sample. Select the forms you’ll need based on the tests you plan to submit.

Forms

Supply request form

Use the Supply Request form to request collection kits, ambient temperature shipping boxes, and other testing supplies.

Please note:

Exclusions may apply depending on the test. For more information, please contact us.
Alaska State Public Health Laboratories do NOT supply blood collection tubes or biohazard bags.
Specimens collected in expired collection devices or transport materials will be rejected as “unsatisfactory” and will not be tested. Please monitor expiration dates carefully.

Lab request forms

Available tests on each form

Anchorage Lab Request form

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Anchorage Lab Request Form includes:

Acid-fast Stain for Oocysts
Aerobic Bacterial Culture
Aeromonas spp.
Bacillus anthracis
Blood Lead
Blood Parasites
Botulinum Neurotoxin
Brucella spp.
Burkholderia spp.
Campylobacter spp.
Candida spp.
Carbapenem-resistant Organisms
Chemical Terrorism Event
Corynebacterium Diphtheriae
Chlamydia and Gonorrhea
Ebola Virus
Enteric Stool Culture
Francisella Tularensis
Haemophilus spp.
Metals in Urine
Microscopic Examination
Middle East Respiratory Syndrome Coronavirus
Mycoplasma Genitalium
Neisseria Gonorrhoeae (Culture & Susceptibility)
Neisseria Meningitidis (Culture)
Orthopox Viruses
Ova & Parasite Exam
Pertussis PCR
Reference Bacterial Culture
Ricin Toxin
Toxic Alcohols & Ethylene Glycol
Trichomonas NAAT
Whole Genome Sequencing
Yersinia Pestis

Fairbanks Lab Request Form

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Fairbanks Lab Request Form includes:

Hepatitis A Virus
Hepatitis B Virus
Hepatitis C Virus
Herpes Simplex Virus PCR
Herpes Simplex Virus Serology
Human Immunodeficiency Virus
Norovirus PCR
Rabies DFA

Respiratory Pathogens Request Form

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Respiratory Pathogens Request Form includes:

Respiratory Pathogen Panel
- Influenza A H1-2009
- Influenza A H3
- Influenza B
- Respiratory syncytial virus (Groups A & B)
- Rhinovirus/enterovirus (cannot differentiate)
- Parainfluenza (Types 1, 2, 3, and 4)
- Human metapneumovirus
- Adenovirus
- Undifferentiated seasonal coronavirus (HKU1, NL63, 229E, OC43)
- SARS-CoV-2
- Chlamydophila pneumoniae
- Mycoplasma pneumoniae