Vermont Department of Health Laboratory Forms
- Clinical Forms - Includes Submission forms, Specimen Collection forms, Test Kit Order forms, and forms for patient result requests, additional testing, or patient information corrections
- Environmental Forms - Includes Submission forms, Specimen Collection forms, and Test Kit Order forms
- Rabies Forms - Includes Submission form
Clinical Forms
Submission Forms
Specimen Collection Instructions
- Blood Lead
- Enteric Bacteria (VDHL Kit #1)
- Gonorrhea and Chlamydia Amplified (VDHL Kit #7 )
- Gonorrhea Culture
- HIV oral fluid
- HIV serum
- Influenza
- Legionella Culture (VDHL Kit #6)
- Mycobacteriology / Mycology (VDHL Kit #6 )
- Parasitology (VDHL Kit #2)
- Pertussis PCR and/or Culture (VDHL Kit #5 )
- Pinworm (VDHL Kit #17)
- Quantiferon-TB Gold In-tube Guidelines & Specimen Collection Instructions
- Serological Specimens (VHDL Kit # 13 and 14)
Clinical Test Kit Order Forms
Requests for Additional Testing, Results, or Corrections
- Request for Additional Clinical Testing - Submit this form after a specimen has been received at the VDHL and additional testing is desired
- Request for Patient Results or Corrections - Submit this form when requesting a copy of a patient result or when an error in patient information requires a correction.
Environmental Forms
Submission Forms
Environmental Collection Instructions
- KIT A or AA Presence/Absence for Total Coliform/E. coli
- KIT AG Irrigation Water Presence/Absence for Total Coliform/E. coli
- KIT C Inorganic Chemicals for Homeowners
- KIT IA Inorganic Chemicals for Regulated Systems
- KIT ID Inorganic Chemicals for Applicable Permitted Systems
- Kit NU Presence/Absence for Total Coliform/E. coli Count
- KIT N3 Nitrate testing
- KIT N2 Nitrite testing
- KIT OE Herbicide testing in Water
- KIT OG Carbamate Pesticides testing
- KIT OH Ethylenedibromide (EDB) and Dibromochlopropane (DBCP)
- KIT OK Haloacetic Acids
- KIT OL Semi-Volatile Chemicals and Pesticides
- KIT RA Gross Alpha (for Homeowners and Regulated systems)
- KIT RC Radon in Water
- KIT RU Uranium in WAter (EPA Method 200.8)
- KIT SW Recreation Water Presence/Absence for E. coli
Rabies Forms
Questions?
Contact Customer Service: (800) 660-9997 (In Vermont) or (802) 863-7336
The Lab's customer service staff responds to internal and external customer inquiries, performs data entry of test information, assembles and processes orders for test kits, and mails all test results.
To order a Specimen Collection Kit, call Kit Ordering at (800) 660-9997 or (802) 863-7560.
For questions regarding results availability, call the Public Health Laboratory Customer Service department at (800) 660-9997 or (802) 863-7336.