Please complete the form below. All ticks should be sent to:

Clongen Laboratories, LLC; 12321 Middlebrook Road, Suite 120, Germantown, MD 20874

Questions? call 301-916-0173 or 877-CLONGEN

Patient’s Name:

Address:

E-mail:

Phone:

Fax:

Physician’s Name (Optional):

Physician’s Phone: (Optional):

Physician’s Fax (Optional):

Check Credit Card (We accept all major credit cards: VISA, MC, AMEX & Discover)

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Authorized Amount ($75 for Tick Testing Test 124C):

Comments/Questions:  

Frequently Asked Questions:

Q: I removed a tick one week ago and it has been stored at room temperature. Would the test still be valid?

A: Yes. Our assay tests DNA and DNA is stable at room temperature. The results will not be impacted.

Q: I stored the tick in alcohol. Would the test still be valid?

A: Yes. Alcohol is a preservative and the tick can be tested.

Q: While removing the tick, I lost the body and trunk of the tick and have only the legs left. Would that be good enough for the test?

A: No. The bacteria is usually in the digestive tract and it is necessary that we receive the entire tick in order to get reliable results.

Q: I was bitten by a tick and there is a red spot/rash. What do I do?

A: See your doctor immediately.

Q: What is the turnaround time for test 124C?

A: Turnaround time is 1-3 days. We usually send results by e-mail as soon as they become available and hard copies along with a receipt follow two to three days later.

Thank you for Choosing Clongen – We appreciate your business.