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State of Hawaii, Department of Health

Public Health & Environmental Laboratories

Ka ʻOihana Olakino
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Forms

  • Medical Cannabis Testing Facility Application
  • CDC Outbreak Report of Suspected Viral Gastroenteritis
  • CDC Specimen Submission Form
  • Chemical Response Laboratory Chain of Custody
  • Clinical Specimen Submission Form – SLD Form 81.3
  • Environmental Samples Submission Form – Biological
  • Influenza Specimen Submission Form 
  • Laboratory Response Network Chain of Custody
  • West Nile Virus Initial Case & Lab Submission Form

License Forms: A through D are applicable to all 5 license types below

  • Attachment A: Approved Agencies for Evaluation of Foreign Credentials
  • Attachment B:  Organizations Providing Certification Examination for State Licensure of Clinical Laboratory Personnel
  • Attachment C: Verification of Certification by Written Examination
  • Attachment D: Fees for Clinical Laboratory Personnel License
  • Hawaii Administrative Rules – Title 11

Clinical Laboratory Director

  • Instructions for the Application
  • Minimum Requirements
  • Application for Licensure
  • Verification of Certification

Clinical Laboratory Specialist

  • Instructions for the Application
  • Minimum Requirements
  • Application for Licensure

Cytotechnologist

  • Instructions for the Application
  • Minimum Requirements
  • Application for Licensure

Medical Technologist

  • Instructions for the Application
  • Minimum Requirements
  • Application for Licensure

Medical Laboratory Technician

  • Instructions for the Application
  • Minimum Requirements
  • Application for Licensure

More Information and Links of Interest

  • Association of Public Health Laboratories (APHL)
  • Centers for Disease Control and Prevention (CDC)
  • Food Emergency Response Network (FERN)
  • Sentinel Level Clinical Microbiology Laboratory Guidelines
  • U.S. Environmental Protection Agency (EPA)
  • USDA Animal & Plant Health Inspection Service
  • U.S. Food & Drug Administration (FDA)

About Us

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  • Info Line 808-586-4400

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