Plant Sample Submission Form

Please follow the instructions below to submit a plant sample for analysis and diagnosis.

 Submit a Sample

Sampling and Submission Instructions

  1. Create one submission form per plant species. A sample from a different plant species must be attached to a separate form. After submitting the form, print it and attach it to the physical sample to complete your sample submission.

  2. Samples should be collected on the day you plan to submit them. Individual samples should be taken from symptomatic tissue, or parts of plants, of the same species. Multiple samples can be taken from the same species and should be taped together with one form.   

    Samples can be shipped or delivered to the following address: 

    Nevada Department of Agriculture
    ATTN: Plant Pathology Laboratory
    405 S. 21st Street
    Sparks, NV 89431

  3. If needed, email additional information such as disease or damage photos, cultural maintenance history, spray history, and other information not reflected in this form to plantpathology@agri.nv.gov with the subject line reflecting the 18-digit submission ID populated upon form submission.

How to complete the Submission Form


How to complete the Submission Form
 Field INSTRUCTIONS and Notes
 SUBMITTED BY
 Full name*  Enter your full name. Reports will be sent to the sender only. This field is required.
 Email  Enter the email address where you would like the completed report delivered. 

 Mailing Street

  Enter your mailing street address and number. Reports will be sent to this address by mail if an email address is not provided. This field is required. 
 Mailing
 City, state, zip*		  Enter your mailing city, state and zip code in the following format: City, ST #####
 Reports will be sent to this address by mail if an email address is not provided. This field is required.
 Date of submission*  Enter the date the sample is being submitted, not the date of collection (if they are different). When possible, send samples on the same day as collected. This field is required. 
 Submitter Reference ID  Enter your own sample reference number if you have one. This field is optional.
 Submitter type    Select from the drop-down menu which category you identify with. This field is optional but helps us tailor the report for your use 
 SERVICE
 Issue*  Select from the drop-down menu which description matches your situation. This field is required
 Regulatory diagnosis  This section is for state inspectors to specify sample categories. Clients submitting samples for cause diagnosis can skip this. 
 Specific pathogen test  Check one or more items if you request specific pathogen tests. Leave blank if unsure. 
 HOST PLANT DATA
 Common name of plant  A common name is an English name given to the plant. For example, Chinese fan palm, tanoak, tomato, ryegrass, etc. Type the common name of the plant from which you collected samples. A list of common names will automatically populate. Select the correct plant name. You may leave this field blank if you are unsure.
 Scientific name of plant  This is auto populated from the chosen common name of plant
 Approximate age of plant    Provide information on the age of the plant or crop (i.e. less than one year, newly  planted, 35 years, etc.). Leave blank if unknown.
 Damage characteristics  Select the most applicable option reflective of your observations from the drop-down menu.  
 Affected plant parts   Check all options that apply.
 Plant symptoms   Check all options that apply. 
 SAMPLE
 Type of sample   Select one from the drop-down menu.
 Location  Enter information on the location where your sample is collected. Please be as specific as possible. 
 Nursery/Field   State Inspector use only
 Remarks  State Inspector use only
 ENVIRONMENT
 Irrigation type  Select what kind of irrigation the plant has received from the drop-down menu.
 Watering frequency  Select how often the plant is watered from the drop-down menu.
 Fertilization frequency  Select how often the plant is fertilized from the drop-down menu.
 Treatments applied in last   6 months  Check all treatments that have been applied in the last 6 months.
 REPORT USE
 How will this report be used?  Select from the drop-down menu. Your selection will be used to tailor the report for your needs and use.
 PROBLEM DESCRIPTION 
 Describe the nature and   extent of the problem  Describe the nature and extent of the problem based on your on-site observations. Responses are limited to 1,800 characters.