Phlebotomy Training Checklist Form
Track the completion of essential phlebotomy training tasks. Please complete all sections to document training progress.
Trainee Full Name
*
First Name
Last Name
Date of Training
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Trainer/Supervisor Name
*
First Name
Last Name
Phlebotomy Training Tasks
*
Reviewed safety and infection control procedures
Performed proper hand hygiene
Identified patient correctly and verified orders
Selected and prepared venipuncture site
Applied tourniquet and assembled equipment
Performed venipuncture and collected specimens
Labeled specimens accurately
Disposed of sharps and materials safely
Additional Comments
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