Sample and specimen collection request form

· This form is to be used when DH requests local government to collect specimens or samples as part of an infectious disease investigation. · Please fax or email the completed form to Communicable Diseases Prevention and Control Unit (CDPCU) on fax: 1300 651 170 or email: cdi&r@health.vic.gov.au.. · Ensure container is clearly labelled with all relevant details and the appropriate MDU forms are completed. Keep sample refrigerated at all times.