Sample Collection Log

Appendix C1: Sample Collection Log Sheet

PFAS Exposure Investigation, blood and urine sampling

DLS Study number DLS study Name SAMPLE COLLECTION LOG SHEET
DATE:__________________________	COLLECTION DATE:______________________
VISIT NUMBER:_________________	RECEIVED BY:_____________________________

UC= Urine Cup, BLD= Red top (blood tube for serum yield)

Place a label in the label section of the specimen log sheet.

☒ = SPECIMEN COLLECTED ☐ = SPECIMEN NOT COLLECTED (Please leave blank if specimen is not collected)

LABEL			Comments:	LABEL			Comments:
	UC				UC
	BLD				BLD
LABEL			Comments:	LABEL			Comments:
	UC				UC
	BLD				BLD
LABEL			Comments:	LABEL			Comments:
	UC				UC
	BLD				BLD
LABEL			Comments:	LABEL			Comments:
	UC				UC
	BLD				BLD
LABEL			Comments:	LABEL			Comments:
	UC				UC
	BLD				BLD