Cannabis Lab Test Form
Please complete all required fields to submit your cannabis sample for laboratory testing.
Sample Identification Number or Code
*
Submitter Full Name
*
First Name
Last Name
Submitter Email Address
*
example@example.com
Submitter Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Sample Type
*
Please Select
Flower/Bud
Concentrate/Extract
Edible
Tincture
Topical
Other
Requested Test Panel
*
Potency (THC/CBD)
Terpenes
Pesticides
Microbial Contaminants
Heavy Metals
Residual Solvents
Moisture Content
Other
Sample Collection Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submission Method / Chain-of-Custody
*
In-person drop-off
Courier delivery
Mail/shipping
Other
Sample Quantity (e.g., grams, units)
*
Sample Storage Conditions
Please Select
Room temperature
Refrigerated (2-8°C)
Frozen (below 0°C)
Other
Additional Notes or Special Instructions
Submit Sample
Should be Empty: