Forms & Ordering Information

Order Test Kits

By phone: call 802-338-4736 or 800-660-9997 (toll-free in Vermont).

By mail: download one of the order forms below and mail it to Public Health Laboratory.

By fax: download one of the order forms below and fax it to 802-338-4706.

In person: come to the laboratory at 359 South Park Drive in Colchester during business hours (7:45 a.m. - 4:30 p.m. Monday - Friday) Closed on holidays.

Clinical Testing
Clinical Tests (Click for Instruction Sheets) Kit Names Order Forms
Blood Lead Blood Lead

Blood Lead Test Requisition
Blood Lead Testing Supplies

Bordetella pertussis (Whooping Cough) Kit 5 Test Kit Order Form
Clinical Test Request Form
Ebola Ebola Call Infectious Disease Epidemiology at 802-863-7240 
Enteric Kit 1 Test Kit Order Form
Clinical Test Request Form
Chlamydia and Gonorrhea Kit 7 Test Kit Order Form
Clinical Test Request Form
Influenza (Flu) Kit 9 Test Kit Order Form
Clinical Test Request Form
Legionella Kit 12 Test Kit Order Form
Clinical Test Request Form
Mycobacteria Kit 6 Shipping Instructions
Test Kit Order Form
Clinical Test Request Form
HIV, Oral Fluid HIV (Oral) Test Kit Order Form
Clinical Test Request Form
Parasitology Kit 2 Test Kit Order Form
Clinical Test Request Form
Pinworm Kit 17 Test Kit Order Form
Clinical Test Request Form
Quantiferon-TB Gold Plus Kit 10 Test Kit Order Form
Clinical Test Request Form
Serology Kit 13 & 14 Test Kit Order Form
Clinical Test Request Form
Zika Zika Call 802-338-4736 for a kit.
Clinical Test Request Form
Bacteriology (Reference Identification) Kit 4 Test Kit Order Form
Clinical Test Request Form
Measles PCR Kit 11 Test Kit Order Form
Clinical Test Request Form
Mumps PCR Kit 11 Test Kit Order Form
Clinical Test Request Form
Additional Test (for specimens already tested)  

Request for Additional Testing Form

Request for Patient Results/Corrections to Patient Records

Brucella Antibody  Kit 13 & 14 Test Kit Order Form
Clinical Test Request Form
Francisella Antibody Kit 13 & 14 Test Kit Order Form
Clinical Test Request Form
Hepatitis B/C  Kit 13 & 14 Test Kit Order Form
Clinical Test Request Form
HIV Serum Kit 13 & 14 Test Kit Order Form
Clinical Test Request Form
Measles lgG/IgM Kit 13 & 14 Test Kit Order Form
Clinical Test Request Form
Mumps lgG Kit 13 & 14 Test Kit Order Form
Clinical Test Request Form
Norovirus Kit 23 Call 802-338-4736 for a kit.
Clinical Test Request Form
Rubella lgG/lgM Kit 13 & 14 Test Kit Order Form
Clinical Test Request Form
Syphilis RPR/FTA/FDRL Kit 13 & 14 Test Kit Order Form
Clinical Test Request Form
Varicella lgG Kit 13 & 14 Test Kit Order Form
Clinical Test Request Form
Drinking Water and Radon Testing
Water and Radon Tests (Click for Instructions Sheets) Kit Order Forms Price
Trace Metals & Fluoride (Regulated Systems) IA $125
Trace Metals & Fluoride (Homeowners) IA $125
Coliform/E. coli (Homeowners) A $14
Coliform/E. coli (Regulated Systems) AA $14
Coliform/E. coli (Total) NU $15
Coliform/E. coli (Irrigation Water) AG $15
E. coli from source water (Regulated Systems) LT $15
Lead First Draw (Childcare/School) DC-Lead $12
Inorganic (Private Water) (Childcare/School) DC-Inorganic $74
Coliform/E. coli (Private Water)(Childcare/School) DC-Coliform/E. coli $14
Coliform/E.coli for Recreation Water SW $15
Inorganic Chemicals (Homeowners) C $100
Lead and Copper (Homeowners and Regulated Water) IB $20
Inorganic Chemicals (Some Permitted Systems) ID $90
Inorganic Chemicals (Homeowners) ID $90
Anions (Chloride, Fluoride, Nitrate, Nitrite, Sulfate)(Homeowners) AN $50
Anions (Chloride, Fluoride, Nitrate, Nitrite, Sulfate)(Regulated Water) AN $50
Nitrate and Nitrite (Homeowners) N3N2 $24
Nitrate and Nitrite (Regulated Water) N3N2 $24
Gross Alpha in Water RA $45
Radon in Water RC $25
Radon in Air-Short Term RF $50
Radon in Air-Medium Term RG $25
Radon in Air-Long Term RH $25
Uranium in Water RU $25
Volatile Organic Chemicals OA $120
Trihalomethanes OB $120
Haloacetic Acids OK $150
Synthetic Organic Chemicals Group (OL, OE, OG, OH) SOC Group $630
Semi-Volatile Chemicals and Pesticides OL $250
Herbicides in Water OE $200
Carbamate Pesticides OG $100
Ethylenedibromide and Dibromochloropropane OH $80
Pentachlorophenlo OP $75
Individual Inorganic Tests Individual Tests $10-25
Miscellaneous Test for Homeowners Misc Test call for information
Odor, Alkalinity & Residual Chlorine (Homeowners) OAC call for information
Blue-Green Algae/Cyanobacteria Testing
Blue-Green Algae Tests (Click for Instructions Sheets) Kit Order Forms Price
Blue-Green Algae (Recreational Water) BGA-1 $25
Blue-Green Algae (Public Drinking Water) BGA-2 $25
Blue-Green Algae (Public Drinking Water) BGA-2a $25
Blue-Green Algae (Natural Water) BGA-3 $25
Anatoxin (Blue-Green) Algae (Private Water) ANA-1 (call to order) $75
Anatoxin (Blue-Green) Algae (Public Water) ANA-2 (call to order) $75
Rabies Testing

All rabies testing requests must be pre-approved by Infectious Disease Epidemiology. Call (802) 863-7240 or 1-800-640-4374 (available 24/7) for approval. Then complete the Request for Examination form and read the Shipping and Instruction Sheet.