Completing the Rabies Specimen Requisition Form

(To order WSLH requisition forms with your facility’s name and address preprinted, contact the Clinical Orders Department at 800-862-1088.)

Complete a WSLH rabies requisition form for each specimen in a shipment; complete information is required for effective follow-up of rabies exposures by the Wisconsin Division of Public Health, the Wisconsin Department of Agriculture, Trade and Consumer Protection, the WSLH and local health departments.
In cases of human exposure, include the name, address and phone number of the physician who will take responsibility for patient care so the rabies laboratory result can be rapidly reported.
Include the name and address of the submitter (e.g., veterinary clinic, humane society, etc.) on the requisition form, otherwise the submitter will not receive a laboratory report.
Clearly document on the requisition forms if multiple specimens are submitted in one shipping container to ensure that all specimens are tested.
If specimens from different exposure cases are submitted in the same shipping container, clearly identify (on the specimen and the form) which specimen is associated with each case.
Completed specimen requisition forms should be placed on top of the lid of the foam container, not inside the shipping container with the specimens where they could become contaminated.
Specimens should be delivered to the WSLH (2601 Agriculture Drive, P.O. Box 7904, Madison) from 6 a.m.-4:30 p.m., Monday – Friday, or 6:30 a.m.-12:30 p.m. on Saturday. (Map and directions)