The Participation Request Form is for new participants requesting proficiency testing (PT) and quality control (QC) materials. Complete all sections to avoid delays in the process of your request.If you have any questions, please email NSQAPDMT@cdc.gov or call 770-488-4582. All enrollment applications and additional program requests are not guaranteed and will be reviewed.

GENERAL INFORMATION

Schedule (International)

Registration Deadline is August 31.

Schedule (Domestic)

Registration Deadline is August 31.

LABORATORY AND SHIPPING INFORMATION

Provide physical street address. FedEx will not deliver to PO Boxes

Shipping

Shipping Address: (if different from laboratory address)

Tax ID Number

Any documents, import permits, fees, taxes, or other costs required by your country for release of your package from Customs are your responsibility. If Tax ID Number is not required to receive FedEx shipment, enter N/A

PROGRAM SELECTION

Proficiency Testing Programs

Quality Control Testing Materials

Second-Tier Quality Control Testing Programs - Enrollment not guaranteed and will be subject to review