Lab Specimen Observation Form
Document laboratory specimen details and observations accurately.
Specimen Identification Number
*
Specimen Type
*
Please Select
Blood
Tissue
Urine
Saliva
Swab
Other
Collection Date and Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Collector's Name
*
Source/Location of Specimen
*
Preservation Method
Please Select
Refrigerated
Frozen
Room Temperature
Fixed in Formalin
Other
Observation Date and Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Observed Findings
*
Specimen Condition/Status
*
Please Select
Intact
Damaged
Contaminated
Degraded
Other
Additional Notes
Submit Observation
Should be Empty: