Serum Conversion and Retrograde Extrapolation Requests

Fill out the Serum/Plasma Conversion & Retrograde Extrapolation form and send it to the Case Management Unit along with the required documents. (see below)

Serum/Plasma Conversion requests must be accompanied by a copy of the medical records laboratory result.      ^{*Conversion cannot be performed on postmortem toxicology reports or breath test instrument results.}

Retrograde Extrapolation requests must be accompanied by a copy of the police report and a copy of the medical records laboratory result.      ^{*Extrapolation cannot be performed if the BAC is 0.03% or less OR if the time interval between incident and blood collection is two hours or less.}

Please note: The medical records provided with the request must correlate with the subject's name.

For Serum Conversion:

The medical records/laboratory results provided must indicate the following:

• If testing was performed on whole blood or serum
• The units for serum results
• That the results are for Ethanol or Ethyl Alcohol testing

*If any of this information is not contained within the medical records it must be provided to the laboratory by the requesting party.

For Retrograde Extrapolation:

The medical records/laboratory results provided must indicate the following:

• If testing was performed on whole blood or serum
• The units for serum results
• That the results are for Ethanol or Ethyl Alcohol testing
• Time of blood draw

The incident report provided must indicate the following:

• Time of the incident or responding officer's arrival to the scene

 *If any of this information is not contained within the medical records it must be provided to the laboratory by the requesting party.