P&PDL Digital Diagnostics
Image Submission
for Insect or Arthropod Sample

Use this form for submitting digital images of insects or arthropods.

Digital Image Sample fees: $11 Indiana, $22 outside Indiana.

Instructions: Fill in the form below with the requested information. A * next to a field denotes required information. Use "NA" if you have no information for the required field. The more information you supply regarding the submitted images and problem, the better we will be able to assist you in identification/diagnosis of the problem.

To upload image file(s), click the "Choose File" or "Browse" button(s) in the Digital Images section and use the open window to find where the image is located on your computer. Select the image you want to upload and then press the "Open" button. The image file name will then appear in the "Image to Upload" field.

If you made a mistake, you may click the "Clear" button to clear the form and start over.

Submitter Information

* - denotes required information. Type "NA" if not applicable or you have no information.

*Submitter name:
*Submitter address 1:
Submitter address 2:
*Submitter city:
*Submitter state:
*Submitter zip:
*Submitter occupation:	Extension Educator Homeowner Farmer Dealer/Industry Rep Golf Course Landscaper Greenhouse Pest Control Operator Nursery Lawn or Tree Care Company Garden Center Consultant Purdue Specialist Other Choose one
*Submitter county:
*Submitter phone:	Include area code.
Submitter fax:	Include area code.
*Submitter email:

Client Information

(If the Client is same as Submitter, please enter "Same" in Client name field.)

Client name:
Client address 1:
Client address 2:
Client city:
*Client state:
Client zip:
*Client occupation:	Extension Educator Homeowner Farmer Dealer/Industry Rep Golf Course Landscaper Greenhouse Pest Control Operator Nursery Lawn or Tree Care Company Garden Center Consultant Purdue Specialist Other Choose one
*Client county:
Client phone:	Include area code.
Client fax:	Include area code.
Client email:

Sample Information

*Information desired:	Information desired: Specimen ID Control recommendation Other (please specify in "Additional information" below)
*Location:	Location found: In dwelling Tree/Shrub Turf/Lawn Golf course Flower bed Vegetable garden Field/Farm Location found, cont.: Greenhouse Nursery Orchard Animal/Human Aquatic Stored grain/Food products Other
*Plant or host:	Enter "NA" if not applicable.
*Problem:	Insect Problem: Damaging plant Biting/stinging Infesting food Nuisance
Numbers of insects/arthropods observed:	Number of insects/arthropods observed: Just a few Many
If found on plants:	% of plants affected:
*Physical sample:	Are you sending a physical sample to the lab? Yes No
Problem description and additional information:

Digital Images

NOTE: Only files ending in ".jpg" or ".jpeg" can be uploaded! (Your images will be renamed during the transfer to the Digital Diagnostics site.) Disclaimer: Images submitted may be used for teaching, extension, training activities, and/or promotion of the Purdue Plant and Pest Diagnostic Lab.
Image to Upload #1:
Image to Upload #2:
Image to Upload #3:
Image to Upload #4:
Image to Upload #5:
Image to Upload #6:
Image to Upload #7:
Image to Upload #8:
Image to Upload #9:
Image to Upload #10:
Please be patient, your image(s) may take a while to upload. A confirmation page will be displayed when the upload has been completed.

The submitter will be billed an $11.00 service fee for in-state submission ($22 out-of-state)
of digital image(s) for diagnosis

Anti-Spam Question - correct response required for submission

	Math Calculation: 6 + 2 =
*Answer:

     

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Plant and Pest Diagnostic Laboratory, Purdue University, West Lafayette, Indiana

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