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Get Fairbanks Lab Request Form V02/27/2017

Ella virus (check specimen type below) NP swab in UTM Influenza & Respiratory Syncytial Virus (RSV) PCR - Surveillance Scab Date of Rash or Parotitis (mumps only) Vaccination Status *Other If the desired test is not on this form, please review the Anchorage Public Health Lab Request Form (http://dhss.alaska.gov/dph/Labs/Documents/ publications/AncSupplyReq.pdf).Contact the laboratory to request testing for Biological/Chemical Terrorism Agents. Immunization Check -.

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