Specimen Kit & Test Request Forms
Specimen Kit Requisition Form
To order specimen kits online, open the Specimen Kit Order Form and indicate the requested quantity next to the item being ordered. Email the requisition form by selecting the Email button in the upper right hand corner of the form.
Each kit consists of a Specimen Container, Properly Addressed Mailing Label, Test Request Forms and List of Contents. Clinical Test Request Forms are not available in the kit and can be accessed in the link below.
For questions or ordering specimen kits by phone, please call (573)751-4830.
Test Request Forms
To access the clinical test request form select: Test Request Form
Test Request Form Guidelines
This form is not used for Blood Lead and Newborn Screening. If you have problems downloading the form, try the following:
- Ensure that Internet Explorer Version 6 or higher is being used. The forms will not open if Firefox is used as the web browser.
- Ensure that Adobe Reader Version 9 or higher is installed on the computer.
- Open Adobe Reader, select Edit, select Preferences, and select Internet. Uncheck the Display PDF in browser checkbox.
- If you receive a Server Error type, close Internet Explorer completely and go back to the 'Test Request Form’ link again.
All other test request forms such as Blood Lead, Drinking Water, and Food Analysis, are available in the specimen kit or available through the links below. See how to order specimen kits above.
Public Water Bacteriological Analysis Request Form
Chemical Water Testing
Collecting Bacteriological Water Samples from Swimming Pools and Bathing Beaches
Food Specimen Information Sheet
Official Private Water Form (LAB 10G)
Recreational Water Analysis Request Form
Sampling Instructions (LAB 34)
Unofficial Private Water Form (LAB 10C)
For questions or ordering test request forms by phone, please call (573) 751-3334.
Missouri Department of Health & Senior Services