Each of the forms below can be edited electronically and saved on a local hard drive as a pdf file for your convenience. We strongly encourage submitters to electronically enter information into the forms to reduce the chance for errors.
UPDATE: For all COVID-19 test requests, use the following test request form: SFDPHL COVID-19 Requisition Form
For the general test requisition form (most assays), please use the following form: General Requisition Form
If you are a San Francisco Health Network clinical site and are submitting a specimen for chlamydia/gonorrhea or Trichomonas vaginalis TMA, please use the following form: SFHN CT/GC/TV Requisition Form
For clinical laboratories submitting bacterial (non-mycobacteriology) cultures for testing, please use the following form: Bacteriology / Parasitology Requisition Form. For clinical laboratories submitting mycobacteriology cultures for testing, please use the following form: General Requistion Form (including Mycobacteriology)
If you are submitting a specimen or culture to the Centers for Disease Control and Prevention (CDC) through our laboratory, complete the following form and include it with your specimen submission:
For testing for viral and rickettsial diseases, use the form: CDC DASH Form (Viral & Rickettsial) For testing for diseases of bacterial nature use the form: CDC DASH Form (Bacteriology / Parasitology)