Arizona Department of Health Services Home Page Banner
 
Office Home Page 
   
Office of Public Health Microbiology
Serology Submission Forms
 

Reporting Results | Specimen Collection | Serology Home | Serological Tests

All AIDS, Serology and Center for Disease Control (CDC) submission forms are available from the Receiving Department (602) 542-1190.

AIDS

One form must accompany each specimen that is submitted. Due to the confidentiality and anonymity of AIDS testing at the State Lab, DO NOT write the patient’s name on the submission form. The red ID number (upper left corner of form) is the reference number the submitting agency will need when calling into the lab. Make sure that the agency code and address of the submitting agency is included or a delay in sending out a copy of the results will occur. Verify that the red ID number on the specimen correctly matches the HIV submission form; otherwise the specimen will be rejected.

Serology

One form must accompany each specimen submitted.  Please fill in the top portion of the form for patient information.  The more information provided, the better we can perform the requested tests.  Fill in the submitting agency information (agency code, address, phone number and a doctor or contact person) to avoid a delay in receiving the results. 

CDC

A Serology submission form for any specimen that needs to be forwarded to the CDC or is sent by special arrangement for testing should be filled out as completely as possible. The CDC requests additional information (date of specimen collection, date of onset, treatment with drugs, symptoms, travel, immunization, etc.) for their testing, so please supply the information needed to avoid a delay of results. 

ADHS Web Privacy Policy. This page last modified on December 17, 2004.
Copyright 2004 Arizona Department of Health Services. All rights reserved.
General comments, questions, or concerns:  ADHS Webmaster