Ct Laboratory Sample: Chain-Of-Custody Form (Page 2 of 2) in pdf

Ct Laboratory Sample: Chain-Of-Custody Form Page 2

INSTRUCTIONS FOR COMPLETING CHAIN-OF-CUSTODY FORM* (COCF):

A. Collector affixes patient label and evidence tape to each specimen tube or

cup and initials across the evidence tape AND specimen container.

B. Collector insures that patient information appears on the COCF by

completing the gray area OR by affixing a patient sticker in the indicated

area.

C. Collector completes manifest portion of COCF by indicating sample

collection time, date, and specimen type to be shipped.

D. Collector completes signature line one (1.) of the COCF. (provides signature,

printed name, date, time of collection and reason for collection)

E. Collector seals COCF and specimen(s) in provided biohazard bag.

F. Collector places specimen(s) in appropriate storage** and holds for pickup

by DHEC CTU.

*Two COCFs are required for each patient: one for blood samples and a second for urine

samples.

**Blood specimens should be placed in a 4°C refrigerator or on ice packs. Urine

specimens should be placed in a -70°C freezer or on dry ice.

DHEC 1374 (3/2005)

Ct Laboratory Sample: Chain-Of-Custody Form Page 2