State of Alaska Submit-A-Tick Form

This form should be used to submit ticks that have been found in Alaska on people, wildlife, pets, or in the environment. Ticks that are submitted through this program will be included in a long-term database of ticks found in the state. Tick identification and lab testing is most effective on fresh samples, so we ask that you send in your submissions as quickly as possible. Please use separate forms for ticks found on different hosts, dates, or locations.

Please follow the instructions below to ensure your tick arrives safely at our office.

Instructions for Tick Submission

Complete this form, generate a PDF (will be created when you click the "Generate Submission Form" button at the bottom page and reach the confirmation screen), print it, and include it in the package with your tick.
Put the tick into a clean, dry, small plastic or metal container (i.e., vial or small pill bottle). Do not add any liquids or preservatives. If ticks are collected from more than one person or animal, please use separate containers.
Place each container into a Ziploc bag. Label the bag with your name and the date the tick was collected. Place the bag in an envelope or small box for shipping.
Ship your tick using your preferred shipping method, or deliver in person to the Office of the State Veterinarian using the address below.

5251 Dr. Martin Luther King Jr. Avenue
Anchorage, AK 99507

If you would like to be notified regarding the identification of your tick, be sure to include your contact information below, once prompted.

Please note that this service is ONLY for surveillance purposes, NOT for diagnostic purposes. If you require timely results for diagnostic purposes, we encourage you to submit your tick to a private laboratory.

Select the category that best describes yourself or the person submitting the tick:

Date the tick was collected:

MonthDayYear

Tick was found on:

HumanDogCatOther

If the tick was found on a person or an animal, was the tick attached (feeding)?

YesNoUnknown

What is the Alaskan zip code for where you found the tick(s)? If you think you picked up the tick while traveling out of state, please list the Alaska zip code where you first saw the tick.

Please provide any additional information about the host/environment where the tick was found. This might include a description of where you or your pet likely encountered the tick, or the location where you found the wildlife with ticks (landmarks, GPS coordinates, address, etc.):

Has anyone in your household (including pets) traveled OUTSIDE Alaska in the past 2 weeks?

YesNoUnknown

Location of travel:

Travel start date:

MonthDayYear

Travel end date:

MonthDayYear

Has anyone in your household (including pets) traveled WITHIN Alaska in the past 2 weeks?

YesNoUnknown

Location of travel:

Travel start date:

MonthDayYear

Travel end date:

MonthDayYear

How will you be submitting the tick sample?

Office of the State Veterinarian (drop off or direct mail)Veterinary clinicAlaska Department of Fish and Game office

If there is any additional information you would like to provide, please include it below.

Would you like to provide contact information to receive notification about tick identification of the submitted specimen(s)? *

Note: This service is ONLY for surveillance purposes, NOT for diagnostic purposes. If you require timely results for diagnostic purposes, we encourage you to submit your tick to a private laboratory.

Name

First NameLast Name

Phone Number

Area CodePhone Number

Email

example@example.com

Please verify that you are human*

Lab Use Only

Received at the EHL by:

Date/time received:

EHL WO#:

OSV TK#:

Received at the EHL by: Date and Time:

EHL WO#: OSV TK#: