Chain of Custody

Reliance Laboratories, Inc. is pleased to offer an Electronic Chain of Custody in a PDF Form. This form will allow users to fill in select fields on their Chain of Custody electronically prior to printing, signing, and submission with the accompanying sample.

Please note that while selected fields may be completed online, no information will be transmitted to Reliance Laboratories electronically and a signed Chain of Custody must accompany any sample submitted to the laboratory.

Electronic Form

Printable Form

*Those with a later version of Adobe Acrobat may have the option to save the file to their local computer for future use. Users of Adobe reader or other third party programs may complete and print the form from their web browser but will likely not have the option to save the form for future use.

Please use this link to print a blank Chain of Custody Record for later use.

Need a Chain of Custody form by U.S. Mail/email or questions or difficulties accessing this site?
Please contact us at at (304) 842-5285 or via email at

Request Personalized Quote

To learn more about our services or to request a personalized quote, please contact us at or call 304.842.5285


West Virginia Certification

West Virginia

Learn More
West Virginia Certification


Learn More

Reliance Laboratories, Inc.

Environmental Analysts and Consultants • Bridgeport, WV & Martinsburg, WV

Corporate Headquarters | 2044 Meadowbrook Road | P.O. Box 4657 | Bridgeport, WV 26330 | Phone: 304.842.5285
Martinsburg Office | 25 Crimson Circle | Martinsburg, WV 25403 | Phone: 304.596.2084

© 2013 Reliance Laboratories, Inc. All rights reserved. Site design by KBDesign