Title Page

  • Clinical Staff Name

  • Conducted on (Date and Time)

  • Supervisor

Specimen Processing Observation

  • Confirmed correct office location

  • Confirmed ordering provider

  • Confirmed attending provider

  • Confirmed no POC testing (except UA/A1c) in test list

  • Sent order to lab

Specimen Handling

  • Received specimen label

  • Gathered specimen collection container according to labels

  • Specimens correctly labelled

  • Proper specimen handling

  • Specimens placed in correct storage environment

Out of the Norm

  • Reached out to required personnel

  • Referred to reference laboratory directory

  • Manual print labels from Apex


  • Overall Competency Assessment

  • I certify the staff member above has been observed and assessed accurately. If the assessment result is not satisfactory, additional training will be given to the staff member until they are competent with the processing workflow.

  • Supervisor (Signature)

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.