Laboratory Analysis Request Missouri Form PDF Details

As a medical professional, it is important to understand the various forms and documents required for requesting laboratory analysis. The Laboratory Analysis Request Missouri Form is an essential form that facilitates communication between laboratories and practitioners in the state of Missouri. This form typically informs laboratory personnel of the tests requested, pertinent patient information and accompanying guidelines necessary to complete testing. We will go into further detail about this critical document in this blog post, including when you should use it and what information needs to be provided for accurate results.

QuestionAnswer
Form NameLaboratory Analysis Request Missouri Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesDNA, AFIS, Trp, missouri highway patrol lab request

Form Preview Example

LABORATORY ANALYSIS REQUEST

 

 

MISSOURI STATE HIGHWAY PATROL

 

 

CRIME LAB NUMBER

 

 

 

CRIME LABORATORY DIVISION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

GHQ (573)526-6134

 

Trp D Sprfld (417)868-9400

Trp G (417)469-1100

AGENCY CASE NO

 

 

Trp B (660)385-2132

 

Trp D Carthage (417)359-1560

Trp H (816)387-2345

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Trp C (573)431-0166

 

Trp E (573)290-5130

 

 

 

STATUS OF CASE:

NEW

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ADD-ON

 

 

 

 

 

 

 

 

 

 

 

 

 

 

RESUBMIT

SUBMITTING AGENCY

 

TYPE OF CRIME

 

 

 

DATE OF CRIME

COUNTY OF CRIME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INVESTIGATING OFFICER

 

TELEPHONE NUMBER

 

E-MAIL ADDRESS

 

 

 

 

 

 

(

)

 

 

 

 

 

 

 

 

 

If DNA/Trace examinations are needed, are subject(s) reference standards being submitted?

YES NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HAS THIS EVIDENCE BEEN EXAMINED BY ANOTHER LABORATORY?

YES

NO If yes, explain below

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LAST NAME

 

FIRST NAME

 

MI

SEX

 

Suspect

 

DOB

 

SSN

 

SID#

FBI#

 

 

 

 

 

 

 

Victim

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Elimination

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other

 

 

 

 

 

 

 

LAST NAME

 

FIRST NAME

 

MI

SEX

 

Suspect

 

DOB

 

SSN

 

SID#

FBI#

 

 

 

 

 

 

 

Victim

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Elimination

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other

 

 

 

 

 

 

 

LAST NAME

 

FIRST NAME

 

MI

SEX

 

Suspect

 

DOB

 

SSN

 

SID#

FBI#

 

 

 

 

 

 

 

Victim

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Elimination

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other

 

 

 

 

 

 

 

SUMMARY OF INCIDENT: (Information should include where the crime occurred (victim's home, suspect's car); if the suspect and victim were husband & wife, dating, or frequented each other's home or vehicle if the crime occurred in one of those locations. Describe known details of how the crime occurred, e.g, how access gained to property, was deceased bound or moved after death? Was victim stabbed, shot, beaten, and strangled?). A written officer’s report may be attached rather than filling out this field.

Only DNA evidence associated with a putative perpetrator will be considered for entry into CODIS. In addition, all appropriate reference standards (victim, suspect, elimination) MUST be submitted, or a clear explanation given as to why they are unavailable.

DESCRIBE BELOW HOW ITEM(S) IS RELATED TO INCIDENT

ITEM DESCRIPTION

AGENCY

ITEM #

EXAM REQUESTED

(See back for specific exam requests)

OWNER OF ITEM

(Ex: Victim, Suspect, other)

SEIZURE LOCATION OF ITEM (Ex: Suspect’s car, victim’s home)

ADDITIONAL INFORMATION

SIGNATURE OF PERSON FILLING OUT FORM

DATE

Approval Date:

5/16/12

Page 1 of 2

Authorized by:

Robin L. Rothove

Rev. 0

LABORATORY ANALYSIS REQUEST

EXAM REQUESTS

DNA Exams

1.DNA Analysis --for sexual assault kits, buccal swabs, swabs from item at crime scenes, or clothing that needs tested for non- stain DNA such as hats, masks or gloves.

2.Blood Detection (for DNA)--for items that are to be examined for the presence of blood that will be tested for DNA.

3.Semen Detection (for DNA)--for items that are to be examined for the presence of semen that will be tested for DNA.

Drug Chemistry

1.Marihuana Analysis--for items that are suspected of being or containing marihuana.

2.Drug Analysis--for items suspected of being or containing controlled substances, but not including marihuana.

Firearm/Toolmark

1.Firearm/Ammunition Examination--for firearm examinations and comparisons of ammunition components.

2.Tool Mark Examinations--for comparing tools to toolmarks.

3.Serial Number Restoration--for items with defaced serial numbers that are to be restored.

4.Impression (tire/footwear examination) -- for examination of tire/footwear impressions.

5.Shooting Distance -- for items such as clothing that need to be analyzed for muzzle-to-target distance determination. This exam involves clothing with a suspect bullet hole.

Latent Prints

1.Latent Print Processing--for evidentiary items to be processed to develop latent prints. Latent comparisons and/or AFIS entry are assumed if latent prints of value are developed.

2.Latent Print Comparison--for comparisons of latent prints developed at the scene with known exemplars. AFIS entry is assumed if manual comparisons with known exemplars yield negative results or if there are no known subjects listed.

3.AFIS Entry-- for latent prints to be searched through the AFIS database. This is to be selected only at GHQ lab by agencies who employ latent print examiners to conduct manual verification of AFIS results.

4.Postmortem Identification -- for comparisons and/or AFIS entry of postmortem prints.

Toxicology

1.Blood Alcohol Analysis--to determine alcohol content in blood samples.

2.Urine Drug Analysis--for urine samples to be analyzed for drugs.

3.Blood Drug Analysis--for blood samples to be analyzed for drugs.

4.Blood Carbon Monoxide Analysis--for blood samples to be analyzed for carbon monoxide.

5.Foreign Substance (food/drink-poison)--for blood, urine, stomach contents, etc to be analyzed for drugs or other poisonous or harmful substances.

6.Alcoholic Beverage Analysis--to determine alcohol content in commercial products.

Trace Evidence

1.Explosives analysis--for pre-blast and post-blast items or suspected explosives.

2.Filament (on/off for vehicle accidents)--for lamps from automobiles and boats to determine if on or off at time of accident.

3.Flammable (fire investigation)--for identification of flammable liquids or the presence of flammable liquid residues on fire debris.

4.Fracture Match (broken/torn)--for broken or torn items to determine if originally one piece.

5.Glass (processing/analysis)--for the detection, collection or comparison of glass standards and questioned glass particles from shoes, clothes or other sources.

6.Gunshot Residue Kit Analysis--for kits taken from hands or other surfaces. Kits taken from shooting victims will not typically be analyzed.

7.Gunshot Residue (Except kits)--for items such as clothing that need to be sampled for the presence of gunshot residue. Clothing is typically limited to gloves and long sleeve shirts and jackets.

8.Hair/Fiber (Trace exams only)--for the detection, collection or comparison of hairs, fiber standards, and fibers from shoes, clothes or other sources. DNA exams will be performed on hair if possible or necessary.

9.Hair (with DNA)--for items that contain hair or are to be examined for the presence of hair that have been submitted with other items needing DNA exams.

10.Paint Analysis--for the comparison of paint standards and transfers.

11.Physical Characteristics Comparison--for comparison of items such as tape, wood, plastics and other miscellaneous materials.

12.Soil (collect/compare)--for the detection, collection or comparison of soil standards and questioned soil samples from shoes, clothes or other sources.

13.Substance ID (unknown/tampering)--for substances suspected of being harmful or causing property damage that may be found in food, mail or on damaged property

Approval Date:

5/16/12

Page 2 of 2

Authorized by:

Robin L. Rothove

Rev. 0