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Clinical Shipping Manifest

Clinical Shipping Manifest

COVID-19/Flu Electronic Test Request Form

All facilities should use the "COVID-19/Flu Electronic Test Request Form" that is part of the OpenELIS Web Portal to order the 2019 Novel Coronavirus Diagnostic Test, Influenza SARS-CoV-2 (Flu SC2) Multiplex, SARS-CoV-2 Next Generation Sequencing, and SARS-CoV-2 IgG Antibody tests instead of using the PDF form that is generated below.

Apply for an OpenELIS Web Portal account

Clinical Test Request Forms - Human specimens only

  • A completed test request form is required to perform testing.
  • Affix a patient information label to the test request form or fully complete the information.
  • Specimen must have two identifiers that match the test request form.
  • Mark the test(s) to be performed.
  • Tests on human samples must be ordered by a licensed medical provider.
  • How to complete your test request form

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