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Kits / Quotes / Forms

Order Clinical Kits
Fill out the on-line form and submit it. Our client services section will mail you the bottles, collection instructions, and paperwork needed to collect your samples. Refer to our Clinical Specimen Kit Reference Guide for more information.
 
Order Environmental Kits
Fill out the on-line form and submit it. Our client services section will mail you the bottles, collection instructions, and paperwork needed to collect your samples. Refer to our Environmental Sampling Kit Reference Guide for more information
 
Obtain a Price Quote for Environmental Services
Fill out the on-line form; submit it and our Client Services section will supply you with your requested information. You can also reach the UHL Client Service section by calling 319/335-4500 or 1-800-421-IOWA (4692).


Clinical Forms Environmental Forms Miscellaneous Forms

 
B   C   H   I   M   R   S   V
B
 
Bacteriology Test Request Form Diptheria Collection Instructions
Detects Corynebacterium diphtheriae
Enteric/Norovirus Collection Instructions
Organisms detected: Aeromonas, Campylobacter, E.coli 0157:H7, Salmonella, Shigella, and Yersinia
Legionella Collection Instructions
Collect specimen per submitters facility guidelines
Mycobacteria (AFB) Collection Instructions
Detects Mycobacteria
Ova & Parasite Collection Instructions
Organisms detected include: Cryptosporidium, Entamoeba histolytica, and Giardia
Blood Lead Test Request Form Blood Lead Collection Instructions
 
C
 
Clinical Test Menu
Cystic Fibrosis Test Request Form Cystic Fibrosis Collection Instructions
Iowa Cystic Fibrosis Carrier Screen
 
H
 
HIV Test Request Form
 
I
 
Iowa Invasive Disease Surveillance Test Request Form
 
M
 
Maternal Screening Test Request Form Maternal Screening Collection Instructions
Iowa Maternal Screen
Maternal Screening Pamphlet English/Spanish
Maternal Screening Consent Form English/Spanish
 
R
 
Rabies Test Request Form
 
S
 
Sampling Kit Reference Guide
Serology / QuantiFERON TB Gold Test Request Form Serology / QuantiFERON TB Gold Collection Instructions
Organisms detected include: Hantavirus, Legionella, Lyme disease, Measles, Syphilis, and West Nile Virus
Test for diagnosis of latent tuberculosis. This test may be used instead of the Tuberculin Skin Test (TST).
 
V
 
Viral Detection and Virus and Bact. PCR Test Request Form Viral Detection and Virus and Bact. PCR Collection Instructions
Organisms detected include: Adenovirus, Coxsackie Virus, Cytomegalovirus, Echovirus, Enterovirus, Herpes Simplex Virus, Influenza A&B, Measles, Mumps, Norovirus (Norwalk-like virus),Parainfluenza 1,2&3, Poliovirus, Rhinovirus, Respiratory Syncytial Virus and Varicella Zoster Virus
Bordetella Pertussis Collection Instructions
Organisms detected include: B. pertussis (whooping cough)
 
 


 
A   B   C   D   E   F   G   H   I   L   M   N   O   P   R   S   T   U   V
A
 
Acid Herbicides In Water:
NOT FOR PUBLIC WATER SUPPLY
Bottle #18 Collection Instructions
Amber Glass Quart (unpreserved)
In Soil:
Bottle #17 Collection Instructions
Pint Glass (unpreserved)
Acidity In Water:
Bottle #1 Collection Instructions
Quart Plastic (unpreserved)
In Soil:
Bottle #1 Collection Instructions
Quart Plastic (unpreserved)
Alkalinity In Water:
Bottle #1 Collection Instructions
Quart Plastic (unpreserved)
Ammonia In Water:
Bottle #2 Collection Instructions
8 oz. Plastic (1 mL 1:1 sulfuric acid [H2SO4])
Asbestos In Water:
Bottle #41 Collection Instructions
2 Amber Glass Quarts (unpreserved)
Atrazine Screen (Immunoassay) In Water:
Bottle #14 Collection Instructions
1-40 mL Glass Vial (unpreserved)
 
B
 
BOD (Biochemical Oxygen Demand) In Water:
BOD Bottle #1 Collection Instructions
Quart Plastic (unpreserved)
BTEX / Gas by OA - 1 (Benzene, Toluene, Ethylbenzene, Xylene) COULD ALSO INCLUDE GAS, MTBE
In Water:
Bottle #45 Collection Instructions
3-40 mL Glass Vials (preserved with HCl) + 1 Trip Blank (preserved with HCl)
In Soil:
Bottle #46 Collection Instructions
4 oz. Glass Jar with Septum Lid (unpreserved) + 1 Trip Blank (unpreserved)
Bicarbonate / Carbonate In Water:
Bottle #1 Collection Instructions
Quart Plastic (unpreserved)
In Soil:
Bottle #9 Collection Instructions
8 oz. Plastic (unpreserved)
Boron In Water:
Bottle #1 Collection Instructions
Quart Plastic (unpreserved)
 
C
 
COD (Carbonacious Oxygen Demand) In Water:
Bottle #2 Collection Instructions
8 oz. Plastic (1 mL 1:1 sulfuric acid [H2SO4])
Caffeine In Water:
Bottle #18 Collection Instructions
Amber Glass Quart (unpreserved)
Chloride In Water:
Bottle #1 Collection Instructions
Quart Plastic (unpreserved)
Chlorinated Hydrocarbon Insecticides In Soil:
Bottle #17 Collection Instructions
Pint Glass (unpreserved)
In Water:
NOT FOR PUBLIC WATER SUPPLY
Bottle #18 Collection Instructions
Amber Glass Quart (unpreserved)
Chlorine In Water:
Bottle #1 Collection Instructions
Quart Plastic (unpreserved)
Chlorophyll (if only analyte required) In Water:
Bottle #34 Collection Instructions
Pint Plastic (unpreserved)
Color In Water:
Bottle #1 Collection Instructions
Quart Plastic (unpreserved)
Common Herbicides In Water:
Bottle #18 Collection Instructions
Amber Glass Quart (unpreserved)
In Soil:
Bottle #17 Collection Instructions
Pint Glass (unpreserved)
Conductance In Water:
Bottle #1 Collection Instructions
Quart Plastic (unpreserved)
Corrosivity In Soild Waste:
Bottle #17 Collection Instructions
Pint Glass (unpreserved)
Cyanide In Water:
Bottle #4 Collection Instructions
500 mL Plastic (4-6 pellets sodium hydroxide [NaOH])
In Soil:
Bottle #17 Collection Instructions
Pint Glass (unpreserved)
 
D
 
Detergents (Surfactants) In Water:
Bottle #1 Collection Instructions
Quart Plastic (unpreserved)
 
E
 
Ethanol In Soil:
Bottle #13 Collection Instructions
3-40 mL Glass Vials (unpreserved) + 1 Trip Blank (unpreserved)
Ethylene / Propylene Oxide / Glycol In Water:
Bottle #13 Collection Instructions
3-40 mL Glass Vials (unpreserved) + 1 Trip Blank (unpreserved)
 
F
 
Flash Point In Solid Waste:
Bottle #17 Collection Instructions
Pint Glass (unpreserved)
Fluoride In Water (except private well water):
Bottle #1 Collection Instructions
Quart Plastic (unpreserved)
In Water (private well water):
Bottle #23 Collection Instructions

In Soil:
Bottle #9 Collection Instructions
8 oz. Plastic (unpreserved)
 
G
 
GC/MS Semi-Volatiles (Gas Chromatography / Mass Spectrometry) In Water:
Bottle #18 Collection Instructions
Amber Glass Quart (unpreserved)
GC/MS Volatiles (Gas Chromatography / Mass Spectrometry) In Water (drinking water):
Bottle #15 Collection Instructions
3-40 mL Glass Vials (ascorbic acid [C6H8O6]) + 1 Trip Blank (ascorbic acid) + HCl Dropper
In Water (except drinking water):
Bottle #45 Collection Instructions
3-40 mL Glass Vials (preserved with HCl) + 1 Trip Blank (preserved with HCl)
In Soil:
Bottle #13 Collection Instructions
3-40 mL Glass Vials (unpreserved) + 1 Trip Blank (unpreserved)
Glycol / Ethylene / Propylene Oxide In Water:
Bottle #13 Collection Instructions
3-40 mL Glass Vials (unpreserved) + 1 Trip Blank (unpreserved)
Grease & Oil In Water:
Bottle #3 Collection Instructions
2-Quart Glass (10 mL 1:1 sulfuric acid [H2SO4])
In Soil:
Bottle #17 Collection Instructions
Pint Glass (unpreserved)
Gross Alpha In Water:
Bottle #22 Collection Instructions
Gallon Plastic (unpreserved)
In Soil:
Bottle #1 Collection Instructions
Quart Plastic (unpreserved)
Gross Beta In Water:
Bottle #22 Collection Instructions
Gallon Plastic (unpreserved)
In Soil:
Bottle #1 Collection Instructions
Quart Plastic (unpreserved)
 
H
 
Haloacetic Acids In Water:
Bottle #42 Collection Instructions
3 Amber 40 mL Vials (4 mg (2 grains) ammonium chloride [NH4Cl]) + Trip Blank (ammonium chloride [NH4Cl])
Hardness In Water:
Bottle #1 Collection Instructions
Quart Plastic (unpreserved)
In Soil:
Bottle #9 Collection Instructions
8 oz. Plastic (unpreserved)
Hexachrome In Water:
Bottle #1 Collection Instructions
Quart Plastic (unpreserved)
In Soil:
Bottle #9 Collection Instructions
8 oz. Plastic (unpreserved)
 
I
 
ICP (Inductive Coupled Plasma) Qualitative Metals Scan In Water:
Bottle #7 Collection Instructions
Pint Plastic (4 mL 1:1 nitric acid [HNO3])
Immunoassay (Atrazine Screen) In Water:
Bottle #14 Collection Instructions
1-40 mL Glass Vial (unpreserved)
 
L
 
Lignin & Tannin In Water:
Bottle #18 Collection Instructions
Amber Glass Quart (unpreserved)
Listeria (ready to eat meat) Surface Wipe:
Listeria Bottle #43 Collection Instructions
Sponge/Glove Kit (Neutralizing Buffer)
 
M
 
Metals In Water:
Bottle #7 Collection Instructions
Pint Plastic (4 mL 1:1 nitric acid [HNO3])
In Soil:
Bottle #17 Collection Instructions
Pint Glass (unpreserved)
Metals (single analyte, do not use for mercury) In Water:
Bottle #29 Collection Instructions
8 oz. Plastic (2 mL 1:1 nitric acid [HNO3])
Methamphetamine Surface Wipe:
Bottle #63 Collection Instructions
1-40 mL Screw Top Vial (unpreserved) + 1 Meth Wipe (Isopropyl alcohol)
Minerals In Water:
Bottle #1 Collection Instructions
Quart Plastic (unpreserved)
 
N
 
N-Series (Ammonia, Total Kjeldahl Nitrogen, Nitrate as N) In Water:
Bottle #2 Collection Instructions
8 oz. Plastic (1 mL 1:1 sulfuric acid [H2SO4])
Nitrate In Water (except drinking water):
Bottle #2 Collection Instructions
8 oz. Plastic (1 mL 1:1 sulfuric acid [H2SO4])

SEE SDWA FOR PUBLIC WATER SUPPLY

In Soil:
Bottle #9 Collection Instructions
8 oz. Plastic (unpreserved)
Nitrate / Nitrite, SDWA In Water:
Bottle #37 Collection Instructions
4 oz. Plastic (unpreserved 125 mL)
Nitrite In Water:
Bottle #1 Collection Instructions
8 oz. Plastic (1 mL 1:1 sulfuric acid [H2SO4])
 
O
 
Oil & Grease In Water:
Bottle #3 Collection Instructions
2-Quart Glass (10 mL 1:1 sulfuric acid [H2SO4])
In Soil:
Bottle #17 Collection Instructions
Pint Glass (unpreserved)
Organophosphate Insecticides In Water:
NOT FOR PUBLIC WATER SUPPLY
Bottle #18 Collection Instructions
Amber Glass Quart (unpreserved)
In Soil:
Bottle #17 Collection Instructions
Pint Glass (unpreserved)
Ortho-phosphate In Water:
Ortho-phosphosphate Bottle #9 Collection Instructions
8 oz. Plastic (unpreserved)
In Soil:
Bottle #9 Collection Instructions
8 oz. Plastic (unpreserved)
 
P
 
PAH (Polycyclicaromatic Hydrocarbons) In Water:
Bottle #18 Collection Instructions
Amber Glass Quart (unpreserved)
In Soil:
Bottle #17 Collection Instructions
Pint Glass (unpreserved)
PCB (Polychlorinated Biphenyls) In Oil:
Bottle #14 Collection Instructions
1-40 mL Glass Vial (unpreserved)
In Water:
Bottle #18 Collection Instructions
Amber Glass Quart (unpreserved)
In Soil:
Bottle #17 Collection Instructions
Pint Glass (unpreserved)
Paint Filter Liquid In Soil:
Bottle #17 Collection Instructions
Pint Glass (unpreserved)
Perchlorate In Water:
Bottle #37 Collection Instructions
4 oz. Plastic (unpreserved 125 mL)
pH In Water:
Bottle #1 Collection Instructions
Quart Plastic (unpreserved)
In Soil:
Bottle #9 Collection Instructions
8 oz. Plastic (unpreserved)
Pharmaceuticals In Water:
Bottle #18 Collection Instructions
Amber Glass Quart (unpreserved)
Phosphorus - total In Water:
Bottle #2 Collection Instructions
8 oz. Plastic (1 mL 1:1 sulfuric acid [H2SO4])
Propylene Oxide / Glycol / Ethylene In Water:
Bottle #13 Collection Instructions
3-40 mL Glass Vials (unpreserved) + 1 Trip Blank (unpreserved)
 
R
 
Radium 226 & 228 In Water:
Bottle #22 Collection Instructions
Gallon Plastic (unpreserved)
In Soil:
Bottle #1 Collection Instructions
Quart Plastic (unpreserved)
Radon In Water:
Bottle #27 Collection Instructions
2-40 mL Vials
Reactivity In Solid Waste:
Bottle #17 Collection Instructions
Pint Glass (unpreserved)
 
S
 
Sampling Kit Reference Guide
Safe Drinking Water Act (SDWA)

SDWA - Gross Alpha, Radium 226 & 228		 In Public Water Supply:
Bottle #22 Collection Instructions
Gallon Plastic (unpreserved)
SDWA - Nitrate and/or Nitrite In Public Water Supply:
Bottle #37 Collection Instructions
4 oz. Plastic (unpreserved 125 mL)
SDWA - Regulated & Unregulated SOCs A/S #1 In Public Water Supply:
Bottle #35 Collection Instructions
Amber Glass Quart (sodium thiosulfate [Na2S2O3])
SDWA - Regulated & Unregulated SOCs A/S #2 In Public Water Supply:
Bottle #30 Collection Instructions
120 mL Amber Glass - green cap (sodium thiosulfate [Na2S2O3] + 3 mL buffer)
SDWA - Regulated & Unregulated SOCs A/S #3 In Public Water Supply:
Bottle #35 Collection Instructions
Amber Glass Quart (sodium thiosulfate [Na2S2O3])
SDWA - Regulated & Unregulated SOCs A/S #4 In Public Water Supply:
Bottle #18 Collection Instructions
Amber Glass Quart (sodium thiosulfate [Na2S2O3])
SDWA - Regulated SOCs A/S #5 In Public Water Supply:
Bottle #57 Collection Instructions
3-40 mL Amber Vials (ammonium chloride in a phosphate buffer [NH4Cl/PO4 buffer]) + 1 Trip Blank (ammonium chloride in a phosphate buffer [NH4Cl/PO4 buffer])
SDWA - Regulated SOCs A/S #6 In Public Water Supply:
Bottle #18 Collection Instructions
Amber Glass Quart (unpreserved)
SDWA - Regulated SOCs A/S #7 In Public Water Supply:
Bottle #18 Collection Instructions
Amber Glass Quart (unpreserved)
SDWA - Regulated SOCs A/S #8 In Public Water Supply:
Bottle #31 Collection Instructions
120 mL Amber Glass (sodium thiosulfate [Na2S2O3])
SDWA - Regulated SOCs A/S #9 Diquat In Public Water Supply:
Bottle #39 Collection Instructions
Amber Plastic Quart (sodium thiosulfate [Na2S2O3]) + sulfuric acid [H2SO4] dropper
SDWA - Regulated SOC A/S #10 (Endothall) In Public Water Supply:
Bottle #40 Collection Instructions
120 mL Amber Glass
SDWA - Regulated & Unregulated VOCs In Public Water Supply:
Bottle #15 Collection Instructions
3-40 mL Glass Vials (ascorbic acid [C6H8O6]) + 1 Trip Blank (ascorbic acid) + HCl Dropper
SDWA - Total THMs (Trihalomethanes) In Public Water Supply:
Bottle #6 Collection Instructions
3-40 mL Amber Vials (ascorbic acid [C6H8O6]) + 1 Trip Blank (ascorbic acid) + HCl Dropper
Sealed Source Leak Test Surface Wipe:
Bottle #44 Collection Instructions
1 Cotton Swab + 1 Cotton Smear in Plastic Mailer
Settable Matter In Water:
Bottle #10 Collection Instructions
1/2 gal. Plastic (unpreserved)
Silica In Water:
Bottle #1 Collection Instructions
Quart Plastic (unpreserved)
Sodium In Water:
Bottle #7 Collection Instructions
Pint Plastic (4 mL 1:1 nitric acid [HNO3])
Solids In Water:
Bottle #1 Collection Instructions
Quart Plastic (unpreserved)
Stability Index In Water:
Bottle #1 Collection Instructions
Quart Plastic (unpreserved)
Strontium 90 In Water:
Bottle #22 Collection Instructions
Gallon Plastic (unpreserved)
Sulfate In Water:
Bottle #1 Collection Instructions
Quart Plastic (unpreserved)
Sulfide In Water:
Bottle #9 Collection Instructions
Quart Glass (2 mL zinc acetate [Zn(CH3CO2)2], 6-8 sodium hydroxide [NaOH] pellets)
Sulfite In Water:
Bottle #1 Collection Instructions
Quart Plastic (unpreserved)
Surfactants (Detergents) In Water:
Bottle #1 Collection Instructions
Quart Plastic (unpreserved)
 
T
 
Toxicity Characteristic Leaching Procedure (TCLP)

TCLP - Metals		 In Solids:
Bottle #17 Collection Instructions
Pint Glass (unpreserved)
TCLP - Pesticides In Solids:
Bottle #17 Collection Instructions
Pint Glass (unpreserved)
TCLP - Semi-Volatiles In Solids:
Bottle #17 Collection Instructions
Pint Glass (unpreserved)
TCLP - Volatiles In Solids:
Bottle #13 Collection Instructions
3-40 mL Glass Vials (unpreserved) + 1 Trip Blank (unpreserved)
TKN (Total Kjeldahl Nitrogen) In Water:
Bottle #2 Collection Instructions
8 oz. Plastic (1 mL 1:1 sulfuric acid [H2SO4])
TOC (Total Organic Carbon) In Water:
Bottle #2 Collection Instructions
8 oz. Plastic (1 mL 1:1 sulfuric acid [H2SO4])
TSS (Total Suspended Solids) In Water:
Bottle #9 Collection Instructions
8 oz. Plastic (unpreserved)
TTO Semi-Volatiles (Total Toxic Organics) In Water:
Bottle #18 Collection Instructions
Amber Glass Quart (unpreserved)
TTO Volatiles (Total Toxic Organics) In Water:
Bottle #45 Collection Instructions
3-40 mL Glass Vials (preserved with HCl) + 1 Trip Blank (preserved with HCl)
Tannin & Lignin In Water:
Bottle #18 Collection Instructions
Amber Glass Quart (unpreserved)
Total Extractable Hydrocarbon by OA-2 In Soil:
Bottle #46 Collection Instructions
4 oz. Glass Jar with Septum Lid
In Water:
Bottle #18 Collection Instructions
Amber Glass Quart (unpreserved)
Total Extractable Hydrocarbon In Solid Waste:
Bottle #17 Collection Instructions
Pint Glass (unpreserved)
Total Nitrogen In Water:
Bottle #2 Collection Instructions
8 oz. Plastic (1 mL 1:1 sulfuric acid [H2SO4])
Total Phenol In Water:
Bottle #5 Collection Instructions
Quart Glass (4 mL 1:1 sulfuric acid [H2SO4])
In Soil:
Bottle #17 Collection Instructions
Pint Glass (unpreserved)
Total Residue In Water:
Bottle #1 Collection Instructions
Quart Plastic (unpreserved)
In Soil:
Bottle #9 Collection Instructions
8 oz. Plastic (unpreserved)
Tritium In Water:
Bottle #19 Collection Instructions
120 ml Amber Glass - green cap (unpreserved)
Turbidity In Water:
Bottle #1 Collection Instructions
Quart Plastic (unpreserved)
 
U
 
Uranium by 200.8 In Water:
Bottle #29 Collection Instructions
4 oz. Plastic (1 mL 1:1 nitric acid [HNO3])
Uranium by 908.0 In Water:
Bottle #22 Collection Instructions
Gallon Plastic (unpreserved)
UV254 or UV Absorbance In Water:
Bottle #52 Collection Instructions
2-125 mL Amber Glass with Septa Lid
 
V
 
Volatile Residue In Water:
Bottle #1 Collection Instructions
Quart Plastic (unpreserved)
In Soil:
Bottle #9 Collection Instructions
8 oz. Plastic (unpreserved)
 
 


 
C   E   P   R   W
C
 
Chain of Custody Form
 
E
 
ELIS Web Access Brochure
 
P
 
Pandemic Influenza Call Sheet
PHIMS Web Access Brochure
 
R
 
Request for Paperless Result Delivery
 
W
 
Web Access Form
 
 


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