Information for Tick Submission to the Connecticut Agricultural Experiment Station (CAES) OR Connecticut Veterinary Medical Diagnostic Laboratory (CVMDL) for Testing
Thank you for requesting information about tick testing. Please note:
NDDH does not submit ticks; submissions must be done by the individual.
Individual bitten by the tick should seek medical attention immediately and not wait to receive test results.
The tick is only being tested for causative agents for Lyme Disease, Anaplasmosis and Babesiosis. Ticks also cany other diseases such as Powassan virus, Ehrlichiosis, Tularemia, Southern Tick-Associated Rash Illness (STAR!), Rocky Mountain Spotted Fever, and Borrelia miyamotoi Disease.
Studies show that infected ticks in general need to be attached for at least 36-48 hours to effectively transmit Lyme Disease. Other diseases vary and can be transmitted in as little as 15 minutes.

Connecticut Agricultural Experiment	Connecticut Veterinary Medical Diagnostic	
No Cost.
Reporting time varies largely on
time of year and tick activity.
Results are sent by e-mail only.
Only deer ticks are tested.
Ticks must be engorged to be tested. Ticks should be dry and placed in a
crush-proof container with no liquids or other objects. The container should be tightly sealed and packaged in a padded envelope, or a small sheet ofbubble wrap added to a regular envelope. Mail or
deliver in person.
Instructions and downloadable
form:Qortal.ct.gov/CAES/Tick-
Office/Tick-Office/Information-on- Submittin12:-Ticks	Fees dependent on testing type. See
website or attached chart for details.
Rep01iing time 3-5 business days by	
	email, fax, or mail. Rush testing
available for extra fee.
Any type of tick may be submitted in
any reasonable condition.
Ticks should be double bagged in
Ziplock bags and secured in a padded envelope. Ticks may be dry or kept moist with water wrapped in a piece of paper towel. No other liquids should be used. Ticks should be as intact as
possible. Mail or deliver in person.
Instructions, downloadableform, and
currentfee listing:
cvmdl.uconn.edu/service/tick.QhQ	

Options for tick submission:

Station	Laboratory

Copies of submission forms for each laboratory are included in this packet.
More info can be found at: httQs://www.cdc.gov/ticks/index.html.

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The Conn l'ticut Agricultural Experiment Station
Putting Science to Work for Society since 1875

Tick_Submission Form	Date:	
Instructions: Complete this form and include it with your tick specimen (It is important to print information legibly).
Information on person/health department submitting tick (to whom report will be sent):
(Please identify name and e-mail address of the person/health department official to whom the report will be sent.)

Name:	_

Address:				 City:	State:	Zip Code:	_
E-mail address (required):	Telephone number(s):	

Please note that the Tick Testing Program is intended for the identification and/or testing of ticks which have fed on humans. Ticks removed from pets will be identified, but not tested.

Was this tick removed from a pet? Y		N	
Pet species/name/age:	_

Information on person bitten by tick:

Name (if different from above):	

Address (if different from above):	

Telephone number(s): 	E-mail address (required):	_

Age:.	Gender: M		F	

Date tick was removed:	Part of body where tick was found:	_ Town in which tick was acquired:			
Please submit samples to:
The Connecticut Agricultural Experiment Station, Tick-Testing Laborat01y, Slate Building Room
112,123 Huntington Street, P.O. Box 1106, New Haven, CT 06504
Phone: (203) 974-8500	Fax: (203) 974-8502
Toll Free: 1-(877) 855-2237 WWW.CT.GOV/CAES
An Affirmative Action/Equal Opportunity Employer

IUCONN

COLLEGE OF AGRICULTURE, HEALTH AND NATURAL RESOURCES

Payment Information (ACCWKS0014)
□Paid-Check#: 	Amount$.		_

OFFICE USE ONLY:

□FedEx □UPS □US Mail □Walk-In Date Received by Lab:

Accession Number:

PATHOBIOLOGY AND VETERINARY SCIENCE
Connecticut Veterinary Medical Diagnostic Laboratory
61 North Eagleville Road, Unit 3203
Storrs, CT 06269-3203
Phone: 860-486-3738 Fax: 860-486-3936
httn.;LL_cvmdl.uconn.edu

SUBMISSION FORM FORTICK TESTING FOR PRICING, PLEASE VISIT THE CVMDL WEBSITE
BILLING INFORMATION

Submitter Name:				 BEST daytime phone number: 	_ Mailing Address:					 Fax number: 			 City:			 E-Mail Address(es): 		_ State: 	 Zip Code: 	_ 				

REPORTING INFORMATION	TICK INFORMATION

□ Internet search: where? 	_
□Other: 	 _

□ Newspaper

How did you hear about our service?
□ Word of mouth

Host Name/ID: 	
Was the tick attached or embedded to the skin?

D Yes
If, YES:

D No

D Unknown

Was the tick attached to D Human or D Non-Human?

Report results via (choose preferred method)
□Email	□ Fax	□U.S. Mail

SUBMITTING THE TICI<

Review Page 2 of this submission form for additional information, including packaging instructions, the "Do's and Don'ts of Tick Submissions" and the available PCR test panels.
Please note that in order to prevent a delay in testing and reporting the results, every tick submitted will be tested regardless of the condition, which include ALL factors (e.g. submitted in a foreign substance or the body of the tick is compromised) that may inhibit or impact test results.

Testing will proceed even if submitted ticks are in a condition not ideal for PCR testing.

REQUEST A TEST

Testing Options: Tick Identification ONLY or Testing the Tick for Pathogens It's Known to Transmit Please visit our website for the most current testing fees: http://cvmdl.uconn.edu/service/tick.php
D Tick Identification ONLY (NOTE: Tick Identification is included with PCR test selection fees)
D Identify the tick and proceed with the appropriate PCR test panel based on the type (species) oftick submitted. The lab will ensure that only the correct tests will be performed on the tick.
D Test ONLY for Borrelia burgdorferi (the causative agent of Lyme disease) if applicable. NOTE: If the submitted tick has not been shown to transmit the bacteria, then only the Tick Identification will be reported. The tick will not be tested.
D RUSH SERVICE - For gn qc/J:/itional fee. Results are available in two business days if the tick is received before 2:00 PM.

ACCDOC0007, Submission Form for Tick Testing; Version: 1.5	Effecliue Dale: 10/24/2018	Page 1 of2

Connecticut Veterinary Medical Diagnostic Laboratory Tick Testing Fee
Current as o/08/08/2019

,------	••••	'0	I
Test Name	Type of Tick SRpeci?1edn IDTeSt T :e : :i:::s e e	I	Comment

I 	 	

eqmre	ays	D ays )

.	.	,

.
- Does not iclude PCR testing for
$lO.OO+	Pathogens

Tick Identification	Any	Tick	M-F	1_2		$5.?0.	-Any specimen Only					Accesswnmg submitted that is
Fee

b	d BorreIz.a

DeerTick,

FT k FM-F	_
FF--F

$50.00+

not a tick may require more time to identify
.

.r. . (L	Human and

3 5	$5.00	Includes Tick

urg D r;en ) yme Non-Human	ic	Accessioning	Identification isease	Host			Fee

Fl

DeerTick,	-	$-l:- --?-OOO-.+-	,

Human Host

$1:0e O+	tht lspecbies_ottftdhe

Deer Ti.ck , FF

5	Accesswmng Fee

NonH-Houstman	Tick	M-F	3-5	A ccess·w. nm•

$1$050.0000+

g

- Fee is

determ·medb y

:

Comprehensive

F.

:: Tick PCR testing	FFTickJ-M--F	=3--5 --A	$

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5

0

·? .	the number of

1	Panel	ccessiomng
·	.-----	Fee	pathogens that

',	Lon star	Tick	M-F	3-5

$1250.000+	tickspecies

Tick

$ ·?  .	carries, and the

Accesswmng

:	FF

'	----	Fee	host the tick
$80.00+

Bro n Dog	M-F	3_5		$5.?_0 Tick			Accesswmng
·, -----	Fee

FF
RUSH Service	Any	Tick	M-F	2	$25.00	aaccdosiitca;t:e:d Thieck
Identification
;	.	and PCR Test

Bullseye rash- common symptom of Lyme disease and STAR!

Tularemia

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mammalian species

(Dermacentor variabi/is)

Ehrlichiosis
Agent: Ehrlichia chaffeensis and Ehrlichia ewingii Symptoms: fever, headache, chills, muscle pain, nausea, vomiting, diarrhea, confusion, red eyes Affe cJed Species: humans, dogs, cats

Agent: Francise/la tularensis Symptoms: fever, skin lesions in people, face and eyes redden and become inflamed, chills, headache, exhaustion Affected Species: humans, rabbits, rodents, cats, dogs, sheep, many

Tick Borne Diseases
In New England

Rocky Mountain Spotted Fever
Agent: Rickettsia rickettsii
Symptoms: fever, "spotted" rash, headache, nausea, vomiting, abdominal pain, muscle pain, lack of appetite, red eyes

Dog Tick		

Affe cted Species: humans, dogs

Skin lesions- common symptom of Tularemia
Brown Dog Tick
(Rhipicephalus sanguineus)

LonJ star tick

l

{Amblyomma americanum)

Southern Tick-Associated Rash Illness (STAR!)
Agent: Borrelia /onestari
Symptoms: "bullseye" rash, fatigue, muscle pains, headache
Affected Species: humans

Anaplasmosis
Agent: Anap/asma phagocytophilum

'

Symptoms: fever, severe headache, muscle aches, chills and shaking, nausea, vomiting, abdominal pain Affected Species: humans, dogs, horses, cows

Lyme Disease
Agent: Borre/ia burgdorferi Symptoms: "bullseye" rash (humans only), fever, aching joints, headache, fatigue, neurological involvement
Affected Species: humans, horses, dogs, many others

Deer Tick

Babesiosis
Agent: Babesia microti
Symptoms: (many show none), fever, chills, sweats, headache, body aches, loss of appetite, nausea Affected Species: humans

Borrelia miyamotoi Disease
Agent: Borrelia miyamotoi
Symptoms: fever, chills, headache, body and joint pain, fatigue
Affected Species: humans

Powassan Virus
Agent: Powassan Virus
Symptoms: (many show none), fever, headache, vomiting, weakness, confusion, loss of coordination, speech difficulties, seizures

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COLLEGEOFAGRICULTURE, HEALTH AND NATURAL RESOURCES
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(lxodes scapularis)

 Affected S_p_ecies: humans