Specimen Submission Form

Key points

  • The Centers for Disease Control and Prevention's (CDC) Infectious Diseases Laboratories accepts specimens for laboratory testing.
  • There are two methods for submitting specimens to the CDC.
  • Access resources and general information about how to submit specimens to CDC using the 50.34 Specimen Submission Form.

How to submit specimens to CDC

There are currently two methods for submitters to submit specimens to CDC for testing:

  1. The CDC Test Order and Reporting (CSTOR) Web Portal (preferred)
  2. The CDC 50.34 Specimen Submission Form

Submitters sending specimens to CDC for laboratory testing should supply all pertinent information associated with the specimen(s). This information will allow the laboratory to effectively review the test order and perform the appropriate test(s). The information supplied will be included in the laboratory report.

Specimens submitted for testing must be accompanied by the upgraded CDC 50.34 Specimen Submission Form. Persons with disabilities experiencing problems accessing this document should contact CDC-INFO by:

  • Completing the form using subject "508 Accommodation PR#31".
  • Calling 800-232-4636 (TTY number: 888-232-6348) and ask for 508 Accommodation PR#31.

CDC 50.34 Specimen Submission Form

Available since November 1, 2021, the upgraded CDC 50.34 Specimen Submission Form is designed to be filled out electronically, printed, and sent to CDC along with a sample. It is an offline, standalone desktop application built exclusively on open-source technologies. It provides enhanced capabilities, such as automated, in-app updates, while preserving the ability to generate static PDF submission forms accessible by any standard PDF viewer application.

All specimens submitted for testing must be accompanied by the upgraded CDC 50.34 Specimen Submission Form. This form should not be sent via unsecure email because of PII data.

For more information about electronic submission through the CSTOR Web Portal—CDC's preferred specimen submission process available to State Public Health Laboratories (SPHLs) and original submitters—please visit this webpage.

Features of the form

  • Contains picklists to select the correct form, order valid tests, and enter accurate information
  • Includes Interactive Test Directory
  • Transfers data accurately using barcodes
  • Downloads and saves data
  • Updates automatically when an internet connection is detected
  • Maintains offline accessibility when in the field

If you have any questions about the form or the submission process, check the "General specimen submission form information" section or the "Resources" Section to view a training webinar on the upgraded submission form and view form-specific training manuals.

Downloading the CDC 50.34 Specimen Submission Form

  • Click on the "CDC Form 50.34 Application" link.
    • This will open a new tab in your browser where you can download the 50.34 installer.
  • Click "Download" to download the installer for the CDC Form 50.34 Application.

Persons with disabilities experiencing problems accessing this document should contact CDC-INFO by:

  • Completing the form using subject "508 Accommodation PR#31".
  • Calling 800-232-4636 (TTY number: 888-232-6348) and ask for 508 Accommodation PR#31.

For more details, please access this Job Aid.

General specimen submission form information

Completing the form

Here are some important DOs and DON'Ts that highlight common errors users make with the CDC 50.34 Specimen Submission Form.

Do

  • Complete one form for each specimen you submit.
  • Fill out the form electronically.
  • Print front and back pages of the form at the same time.
  • For submitters outside of the state public health laboratory (SPHL), please contact your local SPHL for assistance in completing the submitter information on the 50.34 form.

Don't

  • Use unofficial submitter information in the SPHL block of the form, such as your own name, email, phone number, etc.
  • Submit multiple specimens using one form.
  • Handwrite or place labels/stickers on the form.
  • Print front and back pages of the form at different times (doing this disables the barcodes from being scanned by CDC).
  • Send specimens directly to CDC without permission of your SPHL.

The Infectious Diseases Specimen Submission (IDSS) Help Desk serves as the central point of contact for submitters of specimens who have questions or issues related to submitting specimens to CDC, including completing and submitting the CDC 50.34 Specimen Submission Form and using the Test Directory for selecting specific test orders. Questions regarding the detailed information contained within a test order should be addressed to the contact person listed for that test order.

Infectious Diseases Specimen Submission (IDSS) Help Desk‎‎

Email: CDC_ID_lab_info@cdc.gov
Phone (Toll free): 1-855-612-7575
The IDSS Help Desk hours of operation are:
M–F: 8:00 a.m. to 5:00 p.m. EST
Closed on federal holidays.

Submitting multiple specimens

A completed CDC 50.34 Specimen Submission Form must be supplied with each specimen received at CDC (i.e., one specimen per form). If a submitter is sending in a large number of specimens, the submitter may work with a CDC laboratory to submit specimens using a batch form.

Completed specimen submission forms are available to the staff who are involved in the submission of the specimen(s), which include epidemiologists.

Form updates

You can see the latest update by looking at the bottom right of the form for the version number and expiration date. The form will be reviewed frequently for updates and will receive a new version number and expiration date each time it is updated. If an update is required when the form is opened, the form will automatically update, as long as the form has been downloaded to the computer and the computer is connected to the internet. Both the State Public Health Laboratories and the CDC laboratories should educate submitters that an upgraded form is required for submissions.

Supplemental form submission

Send supplemental forms and the CDC 50.34 Specimen Submission Form with your specimen. Laboratory-specific forms are needed by some CDC laboratories in addition to the 50.34 form to perform certain tests. When those test orders are selected on the CDC 50.34 Specimen Submission Form, a link will appear as a reminder that an additional form or approval is required.

Changes to the form

If you must make changes to your form, you must reprint and submit the entire new form. Submitters must reprint both pages of the form to ensure that the updated information gets encoded into the appropriate barcode(s), and to ensure the linkage between the barcodes is maintained.

Barcodes and expirations on the form

  • CDC 50.34 Specimen Submission Form information is validated and encoded in the barcodes when the form is printed. The barcode is hidden until the minimally required fields are completed on the form.
  • Printing the form on a black/white or color printer are both acceptable.
  • Expiration alerts are built directly into the CDC 50.34 Specimen Submission Form and will appear when a user opens an expiring form on their computer.

Additional guidance

The CDC Infectious Diseases Laboratories offer various services for laboratory testing. CDC often receives inquiries regarding information concerning submission forms, testing services, and laboratory reporting. Below is a list of inquiries and responses pertaining to these services. This list will be updated as more inquiries are received, and responses are complete.

If you want to share the CDC Specimen Submission Form 50.34 with your SPHL information, you can complete the SPHL submitter information in the Adobe fillable form and save the PDF. The PDF file with your SPHL submitter information can then be shared. Information populated on the form cannot be locked.

Yes, CDC recognizes that a SPHL's points of contact may vary per submission, and therefore CDC can store multiple points of contact for each submitting organization. In contrast, there should only be one Laboratory Director for each SPHL.

A formal request will need to be submitted to the helpdesk at CDC_ID_Lab.info@cdc.gov (404-639-2176 locally, or 1-855-612-7575 toll-free) to inform CDC of the change to the SPHL information.

Yes. If they are the original submitter of a specimen, then local and county public health laboratories would fill out the original submitter box when submitting the CDC Specimen Submission Form 50.34. The State should supply the form with the acceptable SPHL submitter information already completed to local and county public health laboratories that have permission to submit directly to CDC.

Yes, saved PHL submitter information is retained when changing the specimen origin (e.g. switching the form from human to animal).

They fill out the top submitter block and complete the rest of the form as appropriate. If language is a barrier to completing the form, the submitter must contact an appropriate CDC laboratory to establish a process for submitting specimens to CDC.

Only one test order code/name can be entered on the CDC Specimen Submission Form 50.34. It should be noted that these fields are drop down values on the form and a test order may encompass a panel of multiple tests.

The field 'Specimen Source Modifier' allows one to say if the specimen is acute or convalescent. For noting what it is paired to, or part of a set, then a submitter could use the 'Brief Clinical Summary' or 'Previous Laboratory Results' fields for denoting this information, both located on the back side of the form. The Extent area on the back side of the form allows one to define a particular outbreak if that is the case.

The submitter should select the blank entry in the drop down list.

No, there is no capability to populate the CDC Specimen Submission Form 50.34 from a LIMS, spreadsheet, or database.

Comments should be added to the field labeled Previous Laboratory Results / Comments, located on the back of the form.