Submit A Tick Sample For Identification Or Testing

Please fill out the following form to submit a tick sample for identification or testing. Your survey responses are important for our active tick-borne disease research projects in Maine. All visible form fields must be completed to submit a sample.

1Contact Information

Full Name Email Address Phone Number (type numbers only): Street Address: City State: Please select your state:Maine Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington D.C. West Virginia Wisconsin Wyoming Zip Code (5 digits)

2Tick Information

Date Tick Was Found: (MM/DD/YYYY) Where You Found the Tick Where was tick found? On A Person On A Dog On A Cat Other If the tick was found on a host, was it attached / feeding when you found it? Was the tick feeding? Yes No

What part of the body was the tick attached to / feeding upon? Which body part? Head Neck Armpit Arm Groin Leg Torso (front) Torso (back)

Age of Person: Select Age: 0-4 5-9 10-14 15-18 19-24 25-34 35-44 45-54 55-64 65+

Gender of Person: Gender of Person: Female Male Other Prefer not to answer

3Activity Survey

Have you travelled outside of the state of Maine within the last two weeks? Please select: Yes No Where you believe the tick originated: Select a Maine county: N/A - Outside of Maine Androscoggin Aroostook Cumberland Franklin Hancock Kennebec Knox Lincoln Oxford Penobscot Piscataquis Sagadahoc Somerset Waldo Washington York

Select an Aroostook County Town: Select a town: Allagash Amity Ashland Bancroft Twp Benedicta Twp Big Twenty Twp Blaine Bridgewater Caribou Cary Twp Castle Hill Caswell Chapman Clayton Lake Twp Connor Twp Cox Patent Cross Lake Twp Crystal Cyr Plt Dudley Twp Dyer Brook E Twp Eagle Lake Easton Forkstown Twp Fort Fairfield Fort Kent Frenchville Garfield Plt Glenwood Plt Grand Isle Hamlin Hammond Haynesville Hersey Hodgdon Houlton Island Falls Limestone Linneus Littleton Ludlow Macwahoc Plt Madawaska Madawaska Lake Twp Mapleton Mars Hill Masardis Merrill Molunkus Twp Monticello Moro Plt Nashville Plt New Canada New Limerick New Sweden North Yarmouth Academy Grant Twp Oakfield Orient Oxbow North Twp Perham Portage Lake Presque Isle Reed Plt Saint Agatha Saint Croix Twp Saint Francis Saint John Plt Scopan Twp Sherman Silver Ridge Twp Sinclair Twp Smyrna Stockholm T1 R5 WELS T10 R3 WELS T10 R6 WELS T10 R7 WELS T10 R8 WELS T11 R10 WELS T11 R11 WELS T11 R12 WELS T11 R13 WELS T11 R15 WELS T11 R16 WELS T11 R17 WELS T11 R4 WELS T11 R7 WELS T11 R8 WELS T11 R9 WELS T12 R10 WELS T12 R11 WELS T12 R12 WELS T12 R13 WELS T12 R14 WELS T12 R15 WELS T12 R16 WELS T12 R17 WELS T12 R7 WELS T12 R8 WELS T12 R9 WELS T13 R10 WELS T13 R11 WELS T13 R12 WELS T13 R13 WELS T13 R14 WELS T13 R15 WELS T13 R16 WELS T13 R5 WELS T13 R7 WELS T13 R8 WELS T13 R9 WELS T14 R10 WELS T14 R11 WELS T14 R12 WELS T14 R13 WELS T14 R14 WELS T14 R15 WELS T14 R16 WELS T14 R5 WELS T14 R6 WELS T14 R7 WELS T14 R8 WELS T14 R9 WELS T15 R10 WELS T15 R11 WELS T15 R12 WELS T15 R13 WELS T15 R14 WELS T15 R15 WELS T15 R5 WELS T15 R6 WELS T15 R8 WELS T15 R9 WELS T16 R12 WELS T16 R13 WELS T16 R14 WELS T16 R5 WELS T16 R6 WELS T16 R8 WELS T16 R9 WELS T17 R12 WELS T17 R13 WELS T17 R14 WELS T17 R3 WELS T18 R10 WELS T18 R11 WELS T18 R12 WELS T18 R13 WELS T19 R11 WELS T19 R12 WELS T2 R4 WELS T3 R3 WELS T3 R4 WELS T4 R3 WELS T7 R5 WELS T8 R3 WELS T8 R5 WELS T9 R3 WELS T9 R4 WELS T9 R5 WELS T9 R7 WELS T9 R8 WELS TA R2 WELS TC R2 WELS TD R2 WELS Upper Molunkus Twp Van Buren Wade Wallagrass Washburn Webbertown Twp Westfield Westmanland Weston Winterville Plt Woodland

Select a Androscoggin County Town: Select a town: Auburn Durham Greene Leeds Lewiston Lisbon Livermore Livermore Falls Mechanic Falls Minot Poland Sabattus Turner Wales

Select a Cumberland County Town: Select a town: Baldwin Bridgton Brunswick Cape Elizabeth Casco Chebeague Island Cumberland Falmouth Freeport Frye Island Gorham Gray Harpswell Harrison Long Island Naples New Gloucester North Yarmouth Portland Pownal Raymond Scarborough Sebago South Portland Standish Westbrook Windham Yarmouth

Select a Franklin County Town: Select a town: Alder Stream Twp Avon Beattie Twp Carrabassett Valley Carthage Chain of Ponds Twp Chesterville Coburn Gore Coplin Plt Dallas Plt Davis Twp Eustis Farmington Freeman Twp Gorham Gore Industry Jay Jim Pond Twp Kibby Twp Kingfield Lang Twp Lowelltown Twp Madrid Twp Massachusetts Gore Merrill Strip Twp Mount Abram Twp New Sharon New Vineyard Perkins Twp Phillips Rangeley Rangeley Plt Redington Twp Salem Twp Sandy River Plt Seven Ponds Twp Skinner Twp Stetsontown Twp Strong Temple Tim Pond Twp Township 6 North of Weld Township D Township E Washington Twp Weld Wilton Wyman Twp

Select a Hancock County Town: Select a town: Amherst Aurora Bar Harbor Blue Hill Brooklin Brooksville Bucksport Castine Cranberry Isles Dedham Deer Isle Eastbrook Ellsworth Fletchers Landing Twp Franklin Frenchboro Gouldsboro Great Pond Hancock Hancock County Island Lamoine Mariaville Mount Desert Oqiton Twp Orland Osborn Otis Penobscot Sedgwick Sorrento Southwest Harbor Stonington Sullivan Surry Swans Island T10 SD BPP T16 MD BPP T22 MD BPP T28 MD BPP T3 ND BPP T32 MD BPP T34 MD BPP T35 MD BPP T39 MD BPP T40 MD BPP T41 MD BPP T7 SD BPP T9 SD BPP Tremont Trenton Verona Island Waltham Winter Harbor

Select a Kennebec County Town: Select a town: Albion Augusta Belgrade Benton Chelsea China Clinton Farmingdale Fayette Gardiner Hallowell Litchfield Manchester Monmouth Mount Vernon Oakland Pittston Randolph Readfield Rome Sidney Unity Twp Vassalboro Vienna Waterville Wayne West Gardiner Windsor Winslow Winthrop

Select a Knox County Town: Select a town: Appleton Camden Criehaven Twp Cushing Friendship Hope Isle au Haut Knox County Island Matinicus Isle Plt Muscle Ridge Twp North Haven Owls Head Rockland Rockport Saint George South Thomaston Thomaston Union Vinalhaven Warren Washington

Select a Lincoln County Town: Select a town: Alna Boothbay Boothbay Harbor Bremen Bristol Damariscotta Dresden Edgecomb Hibberts Gore Jefferson Lincoln County Island Monhegan Island Plt Newcastle Nobleboro Somerville South Bristol Southport Waldoboro Westport Island Whitefield Wiscasset

Select a Oxford County Town: Select a town: Adamstown Twp Albany Twp Andover Andover North Surplus Twp Andover West Surplus Twp Batchelders Grant Twp Bethel Bowmantown Twp Brownfield Buckfield Byron C Surplus Canton Denmark Dixfield Fryeburg Gilead Grafton Twp Greenwood Hanover Hartford Hebron Hiram Lincoln Plt Lovell Lower Cupsuptic Twp Lynchtown Twp Magalloway Plt Mason Twp Mexico Milton Twp Newry Norway Otisfield Oxbow Twp Oxford Paris Parkertown Twp Parmachenee Twp Peru Porter Richardsontown Twp Riley Twp Roxbury Rumford Stoneham Stow Sumner Sweden Township C Upper Cupsuptic Twp Upton Waterford West Paris Woodstock

Select a Penobscot County Town: Select a town: Alton Argyle Twp Bangor Bradford Bradley Brewer Burlington Carmel Carroll Plt Cedar Lake Twp Charleston Chester Clifton Corinna Corinth Dexter Dixmont Drew Plt East Millinocket Eddington Edinburg Enfield Etna Exeter Garland Glenburn Grand Falls Twp Greenbush Greenfield Twp Grindstone Twp Hampden Hermon Herseytown Twp Holden Hopkins Academy Grant Twp Howland Hudson Indian Island Kenduskeag Kingman Twp Lagrange Lakeville Lee Levant Lincoln Long A Twp Lowell Mattamiscontis Twp Mattawamkeag Maxfield Medway Milford Millinocket Mount Chase Newburgh Newport Old Town Orono Orrington Passadumkeag Patten Plymouth Prentiss Twp T7 R3 NBPP Pukakon Twp Seboeis Plt Soldiertown Twp T2 R7 WELS Springfield Stacyville Stetson Summit Twp T1 R6 WELS T1 R8 WELS T2 R8 NWP T2 R8 WELS T2 R9 NWP T3 Indian Purchase Twp T3 R1 NBPP T3 R7 WELS T3 R8 WELS T4 Indian Purchase Twp T4 R7 WELS T4 R8 WELS T5 R7 WELS T5 R8 WELS T6 R6 WELS T6 R7 WELS T6 R8 WELS T7 R6 WELS T7 R7 WELS T7 R8 WELS T8 R6 WELS T8 R7 WELS T8 R8 WELS TA R7 WELS Veazie Veazie Gore Webster Plt Winn Woodville

Select a Piscataquis County Town: Select a town: Abbot Atkinson Twp Barnard Twp Beaver Cove Big Moose Twp Blanchard Twp Bowdoin College Grant East Twp Bowdoin College Grant West Twp Bowerbank Brownville Chesuncook Twp Cove Point Twp Days Academy Grant Twp Dover-Foxcroft Eagle Lake Twp East Middlesex Canal Grant Twp Ebeemee Twp Elliottsville Twp Frenchtown Twp Greenville Guilford Harfords Point Twp Katahdin Iron Works Twp Kineo Twp Kingsbury Plt Lake View Plt Lily Bay Twp Lobster Twp Medford Milo Monson Moosehead Junction Twp Mount Katahdin Twp Nesourdnahunk Twp Northeast Carry Twp Orneville Twp Parkman Piscataquis County Island Rainbow Twp Sandbar Tract Twp Sangerville Sebec Shawtown Twp Shirley Soper Mountain Twp Spencer Bay Twp T1 R10 WELS T1 R11 WELS T1 R12 WELS T1 R13 WELS T1 R9 WELS T10 R10 WELS T10 R11 WELS T10 R12 WELS T10 R13 WELS T10 R14 WELS T10 R15 WELS T10 R9 WELS T2 R10 WELS T2 R12 WELS T2 R13 WELS T2 R9 WELS T3 R10 WELS T3 R11 WELS T3 R12 WELS T3 R13 WELS T4 R10 WELS T4 R11 WELS T4 R12 WELS T4 R13 WELS T4 R14 WELS T4 R15 WELS T4 R9 NWP T4 R9 WELS T5 R11 WELS T5 R12 WELS T5 R14 WELS T5 R15 WELS T5 R9 WELS T6 R10 WELS T6 R11 WELS T6 R12 WELS T6 R13 WELS T6 R14 WELS T6 R15 WELS T7 R10 WELS T7 R11 WELS T7 R12 WELS T7 R13 WELS T7 R14 WELS T7 R15 WELS T7 R9 NWP T7 R9 WELS T8 R10 WELS T8 R11 WELS T8 R14 WELS T8 R15 WELS T8 R9 WELS T9 R10 WELS T9 R11 WELS T9 R12 WELS T9 R13 WELS T9 R14 WELS T9 R15 WELS T9 R9 WELS TA R10 WELS TA R11 WELS TB R10 WELS TB R11 WELS Trout Brook Twp TX R14 WELS Wellington Williamsburg Twp Willimantic

Select a Sagadahoc County Town: Select a town: Arrowsic Bath Bowdoin Bowdoinham Georgetown Perkins Twp Swan Island Phippsburg Richmond Topsham West Bath Woolwich

Select a Somerset County Town: Select a town: Alder Brook Twp Anson Appleton Twp Athens Attean Twp Bald Mountain Twp T2 R3 Bald Mountain Twp T4 R3 Big Six Twp Big Ten Twp Big W Twp Bigelow Twp Bingham Blake Gore Bowtown Twp Bradstreet Twp Brassua Twp Brighton Plt Cambridge Canaan Caratunk Carrying Place Town Twp Carrying Place Twp Chase Stream Twp Comstock Twp Concord Twp Cornville Dead River Twp Dennistown Plt Detroit Dole Brook Twp East Moxie Twp Elm Stream Twp Embden Fairfield Flagstaff Twp Forsyth Twp Hammond Twp Harmony Hartland Highland Plt Hobbstown Twp Holeb Twp Indian Stream Twp Jackman Johnson Mountain Twp King & Bartlett Twp Lexington Twp Little W Twp Long Pond Twp Lower Enchanted Twp Madison Mayfield Twp Mercer Misery Gore Twp Misery Twp Moose River Moscow Moxie Gore New Portland Norridgewock Palmyra Parlin Pond Twp Pierce Pond Twp Pittsfield Pittston Academy Grant Pleasant Ridge Plt Plymouth Twp Prentiss Twp T4 R4 NBKP Ripley Rockwood Strip T1 R1 NBKP Rockwood Strip T2 R1 NBKP Russell Pond Twp Saint Albans Saint John Twp Sandwich Academy Grant Twp Sandy Bay Twp Sapling Twp Seboomook Twp Skowhegan Smithfield Soldiertown Twp T2 R3 NBKP Solon Squaretown Twp Starks T10 R16 WELS T3 R4 BKP WKR T3 R5 BKP WKR T4 R17 WELS T4 R5 NBKP T5 R17 WELS T5 R18 WELS T5 R19 WELS T5 R20 WELS T5 R6 BKP WKR T5 R7 BKP WKR T6 R17 WELS T6 R18 WELS T7 R16 WELS T7 R17 WELS T7 R18 WELS T7 R19 WELS T8 R16 WELS T8 R17 WELS T8 R18 WELS T8 R19 WELS T9 R16 WELS T9 R17 WELS T9 R18 WELS Taunton & Raynham Academy Grant The Forks Plt Thorndike Twp Tomhegan Twp Upper Enchanted Twp West Forks Plt West Middlesex Canal Grant Twp

Select a Waldo County Town: Select a town: Belfast Belmont Brooks Burnham Frankfort Freedom Islesboro Jackson Knox Liberty Lincolnville Monroe Montville Morrill Northport Palermo Prospect Searsmont Searsport Stockton Springs Swanville Thorndike Troy Unity Waldo Winterport

Select a Washington County Town: Select a town: Addison Alexander Baileyville Baring Plt Beals Beddington Berry Twp Big Lake Twp Brookton Twp Calais Cathance Twp Centerville Twp Charlotte Cherryfield Codyville Twp Columbia Columbia Falls Cooper Crawford Cutler Danforth Day Block Twp Deblois Dennysville Devereaux Twp Dyer Twp East Machias Eastport Edmunds Twp Forest City Twp Forest Twp Fowler Twp Grand Lake Stream Plt Greenlaw Chopping Twp Harrington Indian Twp Res Jonesboro Jonesport Kossuth Twp Lambert Lake Twp Lubec Machias Machiasport Marion Twp Marshfield Meddybemps Milbridge Northfield Pembroke Perry Pleasant Point Princeton Robbinston Roque Bluffs Sakom Twp Steuben T11 R3 NBPP T18 MD BPP T19 ED BPP T19 MD BPP T24 MD BPP T25 MD BPP T26 ED BPP T30 MD BPP T36 MD BPP T37 MD BPP T42 MD BPP T43 MD BPP T6 ND BPP T6 R1 NBPP T8 R3 NBPP T8 R4 NBPP Talmadge Topsfield Trescott Twp Vanceboro Waite Washington County Island Wesley Whiting Whitneyville

Select a York County Town: Select a town: Acton Alfred Arundel Berwick Biddeford Buxton Cornish Dayton Eliot Hollis Kennebunk Kennebunkport Kittery Lebanon Limerick Limington Lyman Newfield North Berwick Ogunquit Old Orchard Beach Parsonsfield Saco Sanford Shapleigh South Berwick Waterboro Wells York

If outside of Maine, where?

How would you describe the property where you encountered the tick? Please select a property type: My own residence/property Public lands (parks, trails, etc.) Someone else's private property Other

What activity were you doing when you think you came into contact with the tick? Select an activity:ATV Riding Bicycling Camping Fishing Yardwork / Gardening Hiking Hunting / Trapping Occupational - Agriculture Occupational - Forestry / Logging Occupational - Other Other Pet Related (petting, grooming, walking pet, etc.) Playing Outside Playing Sports Running Walking

Please Describe the Activity

Were you using any type of personal protection to prevent tick bites? Please select: Yes No

Which type(s) of personal protection (repellents, etc.) were you using?
Hold down the Ctrl (Windows) or Command (Mac) key while clicking to make multiple selections. Protective clothing DEET IR3535 Oil of lemon eucalyptus or PMD Other essential oils Other Picaridin Permethrin (treated clothing)

What type of other personal protection were you using?

4Payment Information

Requested service: Select a service: PCR Test my tick - $20 Identify my tick - FREE

Select form of payment: Select a payment type: Credit, Debit, or EFT - $20 Physical Check - $20 Payment by a partnering institution

Enter the 12 digit code provided by your institution:

5Policies and Procedures

I agree to the policies and procedures of the UMaine Cooperative Extension Diagnostic and Research Laboratory. (Link opens in a new window)