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.
Question | Answer |
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Form Name | Laboratory Analysis Request Missouri Form |
Form Length | 2 pages |
Fillable? | No |
Fillable fields | 0 |
Avg. time to fill out | 30 sec |
Other names | DNA, AFIS, Trp, missouri highway patrol lab request |
LABORATORY ANALYSIS REQUEST
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MISSOURI STATE HIGHWAY PATROL |
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CRIME LAB NUMBER |
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CRIME LABORATORY DIVISION |
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GHQ |
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Trp D Sprfld |
Trp G |
AGENCY CASE NO |
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Trp B |
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Trp D Carthage |
Trp H |
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Trp C |
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Trp E |
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STATUS OF CASE: |
NEW |
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RESUBMIT |
SUBMITTING AGENCY |
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TYPE OF CRIME |
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DATE OF CRIME |
COUNTY OF CRIME |
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INVESTIGATING OFFICER |
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TELEPHONE NUMBER |
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If DNA/Trace examinations are needed, are subject(s) reference standards being submitted? |
YES NO |
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HAS THIS EVIDENCE BEEN EXAMINED BY ANOTHER LABORATORY? |
YES |
NO If yes, explain below |
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LAST NAME |
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FIRST NAME |
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SEX |
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Suspect |
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DOB |
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SSN |
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SID# |
FBI# |
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Victim |
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Elimination |
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Other |
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LAST NAME |
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FIRST NAME |
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MI |
SEX |
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Suspect |
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DOB |
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SSN |
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SID# |
FBI# |
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Victim |
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Elimination |
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Other |
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LAST NAME |
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FIRST NAME |
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MI |
SEX |
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Suspect |
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DOB |
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SSN |
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SID# |
FBI# |
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Victim |
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Elimination |
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Other |
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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
2.Blood Detection (for
3.Semen Detection (for
Drug Chemistry
1.Marihuana
2.Drug
Firearm/Toolmark
1.Firearm/Ammunition
2.Tool Mark
3.Serial Number
4.Impression (tire/footwear examination)
5.Shooting Distance
Latent Prints
1.Latent Print
2.Latent Print
3.AFIS
4.Postmortem Identification
Toxicology
1.Blood Alcohol
2.Urine Drug
3.Blood Drug
4.Blood Carbon Monoxide
5.Foreign Substance
6.Alcoholic Beverage
Trace Evidence
1.Explosives
2.Filament (on/off for vehicle
3.Flammable (fire
4.Fracture Match
5.Glass
6.Gunshot Residue Kit
7.Gunshot Residue (Except
8.Hair/Fiber (Trace exams
9.Hair (with
10.Paint
11.Physical Characteristics
12.Soil
13.Substance ID
Approval Date: |
5/16/12 |
Page 2 of 2 |
Authorized by: |
Robin L. Rothove |
Rev. 0 |