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Activity 2 - Phlebotomist Safety Exclusion Questions
ICR 201608-0923-002 · OMB 0923-0054 · Object 67203301.
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| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
|---|---|
| File Title | Activity 2 - Phlebotomist Safety Exclusion Questions |
| Author | CDC User |
| Last Modified By | Writer |
| File Modified | 2016-07-06 |
| File Created | 2026-09-24 |
| Conversion State | complete |
Extracted Text
Attachment 5g. Phlebotomist Safety Exclusion Questions Safety Exclusion Questions (All Participants) Q1. “Do you have hemophilia?” If yes, the participant is ineligible for a blood draw. Inform the participant and thank them for their willingness to participate in this component. If no, the participant is eligible for a blood draw. Proceed with sample collection. Q2. Have you received cancer chemotherapy in the past four weeks? If yes, the participant is ineligible for a blood draw. Inform the participant and thank them for their willingness to participate in this component. If no, the participant is eligible for a blood draw. Proceed with sample collection. Additional Safety Exclusion Questions (for participants < 18 years of age) Q3. Do you weigh less than 25 pounds? If yes: How much do you weigh? _______________________ Maximum blood draw is = (weight/2.2)*3 If no, the participant is eligible for the maximum blood draw required by the study (15mL x 2 collections).