Bacteria Culture Lab Report Form
Complete this form to document bacteria culture lab results, including sample, specimen, culture conditions, findings, and interpretation.
Sample Identification Number
*
Date of Collection
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Specimen/Source Type
*
Please Select
Blood
Urine
Sputum
Wound Swab
CSF
Stool
Other
Site of Collection (if applicable)
Culture Conditions
*
Please Select
Aerobic
Anaerobic
Microaerophilic
Other
Organisms Isolated
*
Colony Morphology/Gram Stain Findings
Antibiotic Susceptibility Results
Interpretation/Comments
*
Reported By (Name/Initials)
*
Submit Report
Should be Empty: