Form FDACS-09213 "Mosquito Arboviral Pcr Testing Submittal Form" - Florida

What Is Form FDACS-09213?

This is a legal form that was released by the Florida Department of Agriculture and Consumer Services - a government authority operating within Florida. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on May 1, 2018;
  • The latest edition provided by the Florida Department of Agriculture and Consumer Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form FDACS-09213 by clicking the link below or browse more documents and templates provided by the Florida Department of Agriculture and Consumer Services.

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Download Form FDACS-09213 "Mosquito Arboviral Pcr Testing Submittal Form" - Florida

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Florida Department of Agriculture and Consumer Services
Contact Information:
Division of Animal Industry
Bronson Animal Disease Diagnostic
Laboratory
Bureau of Diagnostic Laboratory
Tel: (321) 697-1400
Fax: (321) 697-1467
MOSQUITO ARBOVIRAL PCR
TESTING SUBMITTAL FORM
ADAM H. PUTNAM
COMMISSIONER
FreshFromFlorida.com/BADDL
570.36, 585.145, Florida Statutes
Note: All documents and attachments submitted with this request are subject to public review pursuant to Chapter 119, F.S.
SUBMITTER
Name
Address
City
State
Zip Code
County
District
Phone
Fax
Email
Sample ID#
Species
Collection Location
Number
Pooled
(AE = Aedes aegypti, AB = Aedes albopictus,
M = Mixed Aedes sp., O = other species)
□AE
□AB
□M
□O
1
□AE
□AB
□M
□O
2
□AE
□AB
□M
□O
3
□AE
□AB
□M
□O
4
□AE
□AB
□M
□O
5
□AE
□AB
□M
□O
6
□AE
□AB
□M
□O
7
□AE
□AB
□M
□O
8
□AE
□AB
□M
□O
9
□AE
□AB
□M
□O
10
□AE
□AB
□M
□O
11
□AE
□AB
□M
□O
12
□AE
□AB
□M
□O
13
□AE
□AB
□M
□O
14
□AE
□AB
□M
□O
15
SPECIMENS: Number of Specimens Submitted:
Date Collected:
Bronson Animal Disease Diagnostic Laboratory
Delivery Service Address
2700 N John Young Pkwy
Kissimmee, FL 34741-1266
FDACS-09213 Rev. 05/18
Florida Department of Agriculture and Consumer Services
Contact Information:
Division of Animal Industry
Bronson Animal Disease Diagnostic
Laboratory
Bureau of Diagnostic Laboratory
Tel: (321) 697-1400
Fax: (321) 697-1467
MOSQUITO ARBOVIRAL PCR
TESTING SUBMITTAL FORM
ADAM H. PUTNAM
COMMISSIONER
FreshFromFlorida.com/BADDL
570.36, 585.145, Florida Statutes
Note: All documents and attachments submitted with this request are subject to public review pursuant to Chapter 119, F.S.
SUBMITTER
Name
Address
City
State
Zip Code
County
District
Phone
Fax
Email
Sample ID#
Species
Collection Location
Number
Pooled
(AE = Aedes aegypti, AB = Aedes albopictus,
M = Mixed Aedes sp., O = other species)
□AE
□AB
□M
□O
1
□AE
□AB
□M
□O
2
□AE
□AB
□M
□O
3
□AE
□AB
□M
□O
4
□AE
□AB
□M
□O
5
□AE
□AB
□M
□O
6
□AE
□AB
□M
□O
7
□AE
□AB
□M
□O
8
□AE
□AB
□M
□O
9
□AE
□AB
□M
□O
10
□AE
□AB
□M
□O
11
□AE
□AB
□M
□O
12
□AE
□AB
□M
□O
13
□AE
□AB
□M
□O
14
□AE
□AB
□M
□O
15
SPECIMENS: Number of Specimens Submitted:
Date Collected:
Bronson Animal Disease Diagnostic Laboratory
Delivery Service Address
2700 N John Young Pkwy
Kissimmee, FL 34741-1266
FDACS-09213 Rev. 05/18