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This document is a submission form for individuals to report tick samples, specifically deer ticks, including instructions for proper tick removal and sample collection.

How to fill out tick sample submission form

How to fill out Tick Sample Submission Form

1. Obtain the Tick Sample Submission Form from the designated health department or website.
2. Fill in your contact information, including name, address, phone number, and email.
3. Provide details regarding the tick sample, such as species, date of collection, location of collection, and any relevant medical history.
4. Include information about the person from whom the tick was collected, if applicable, including symptoms and exposure history.
5. Sign and date the form to confirm accuracy of the information provided.
6. Submit the completed form along with the tick sample as instructed (either in person or via mail).

Who needs Tick Sample Submission Form?

1. Individuals who have been bitten by a tick.
2. Healthcare professionals seeking to test ticks for Lyme disease or other tick-borne illnesses.
3. Researchers studying tick populations and their epidemiology.
4. Public health officials monitoring tick-related health risks in the community.

People Also Ask about

How do I submit a tick for testing?

How do I get my tick tested? Order the Universal Tick Test online and receive your order #. Secure each tick (dead or alive) in a Ziploc bag. Write account holder name and order number on the envelope/bag/or piece of paper. Send to: TICKNOLOGY, LLC.

Can I send a dead tick in for testing?

What if my tick is dead or damaged? Ticks do not have to be alive to be tested.

How much does it cost to send a tick for testing?

No need to freeze it, put it in alcohol or Listerine, etc. There are many laboratories that will test ticks. The cost depends on how many pathogens you want to test for. It is typically $50 for a basic test.

Can you send a dead tick for testing?

How do I get my tick tested? Order the Universal Tick Test online and receive your order #. Secure each tick (dead or alive) in a Ziploc bag. Write account holder name and order number on the envelope/bag/or piece of paper. Send to: TICKNOLOGY, LLC.

Where to send a tick for testing CT?

Ticks should be submitted by residents to their municipal health departments. The health departments will then submit ticks to us with a request for identification and/or testing for the causative agents for Lyme disease, anaplasmosis, and babesiosis.

For pdfFiller’s FAQs

What is Tick Sample Submission Form?

The Tick Sample Submission Form is a document used to collect and submit tick samples for testing, typically for the purpose of identifying diseases carried by ticks.

Who is required to file Tick Sample Submission Form?

Individuals or organizations that collect tick samples for testing, such as health professionals, researchers, or members of the public who suspect they have been exposed to ticks, are required to file the form.

How to fill out Tick Sample Submission Form?

To fill out the Tick Sample Submission Form, provide the necessary information such as the submitter's contact details, the date of collection, the location where the tick was found, and any relevant health information related to the submitter.

What is the purpose of Tick Sample Submission Form?

The purpose of the Tick Sample Submission Form is to ensure proper identification and testing of tick samples to monitor and manage tick-borne diseases effectively.

What information must be reported on Tick Sample Submission Form?

The information that must be reported includes the submitter's name and contact information, detailed location of tick collection, date of collection, species of the tick (if known), and any symptoms experienced by the submitter.