Syphilis Serum Request Form
CDC and the Association of Public Health Laboratories developed a Syphilis Serum Repository. The repository is composed of residual syphilis positive serum samples tested and submitted by U.S. state and local public health laboratories. Samples may be requested from CDC in order to facilitate research and development of syphilis diagnostic tests. For an explanation of this form and the process to request specimens, see CDC/APHL Syphilis Serum Repository. For any questions about this form, please contact Dr. Weiping Cao at 404-639-5443 or firstname.lastname@example.org.
All fields on the form must be completed in order for a request to be considered.