Petition to Test for Blood-Borne Pathogens

This form is a request to the court to determine if a person was potentially exposed to a blood-borne pathogen and to order testing and the release of those test results. It asks for details about the alleged exposure and which specific viruses should be tested for.

Common questions

Who fills out this form?

The undersigned petitioner fills out this form. The petitioner can be an employee, an agent of a public safety agency, or a person who was potentially exposed to a blood-borne pathogen. Great care must be taken to select the correct option describing the petitioner's role.

What does the court do with this form?

The court can order testing if it finds that an exposure prone incident has occurred. The judge's order will state whether testing is ordered and when the results will be shared with the petitioner.

Revision history

No changes recorded since we started tracking this form on October 10, 2026.

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