IBL Supply Order Request Form
For questions or help with this form, contact IBLSUPORD@dhw.idaho.gov or (208)334-2235 ext. 226.
*Supplies sent with a requested courier is at the cost of the entity requesting the samples.
The Idaho Bureau of Laboratories (IBL) provides selected supplies as no cost, with the understanding that the supplies will be used for submitting samples to IBL for testing.  Quantity limits for select supplies have been established.  Contact IBLSUPORD@dhw.idaho.gov or (208)334-2235 ext. 226 for more information.

The following items are free of charge:
IBL Use Only:

PCA:  _________________________                                  Shipper used:  __________________________

Date supplies sent:  _____________________                     Initials of IBL sender:  ____________________
Please complete the following information (required).

Notes pertinent to your order

Requested supplies to be sent via:

Date of pick up

Name of courier

Date of pick up