Requisitions and Forms

REQUISITIONREVISION DATE

Rabies Requisition Form (PH-4177)

RESTRICTED TO: Public Health Departments, Veterinary Clinics, and those who have received prior authorization for testing from Epidemiology.

                                   7/2024
Clinical Submission Requisition Form (PH-4182)7/2023
COVID-19 Requisition Form (PH-4360)7/2023

Influenza and Viral Respiratory Panel Requisition Form (PH-4149) 

RESTRICTED TO:  Sentinal Provider Network (SPN), EIP Influenza Hospitals, and the Office of the Medical Examiner.

7/2023

Select Agent Rule Out Requisition Form (PH-4263)

 For Sentinel Laboratory Use - Notification required PRIOR to sample submission

7/2023

 

Laboratory Supplies Requisition - Nashville Central Laboratory (PH-1580A)12/2022
Laboratory Supplies Requisition - Knoxville Regional Laboratory (PH-1580C)12/2022