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SPECIMEN COLLECTION FORM for Visit 1a (L01) Kid Chronic Kidney Disease in Children Cohort Study (Kid) SECTION A: GENERAL INFORMATION A1.PARTICIPANT ID: AFFIX ID LABEL OR ENTER NUMBER IF ID LABEL IS

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How to fill out specimen collection form for

01

Fill out your personal information including name, date of birth, and contact information.

02

Indicate the reason for the specimen collection and any relevant medical history.

03

Specify the type of specimen being collected and any specific instructions for the procedure.

04

Include the date and time of collection, as well as the name of the healthcare provider overseeing the process.

05

Sign and date the form to confirm that all information provided is accurate.

Who needs specimen collection form for?

01

Patients undergoing diagnostic testing or medical procedures that require collection of biological samples.

02

Healthcare providers who are responsible for collecting and analyzing specimens from patients.

03

Research institutions conducting studies that involve sample collection for analysis.

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What is specimen collection form for?

The specimen collection form is used to collect and document samples for testing or analysis.

Who is required to file specimen collection form for?

Anyone involved in the collection, transportation, or testing of specimens may be required to file a specimen collection form.

How to fill out specimen collection form for?

To fill out a specimen collection form, provide all requested information about the specimen being collected, the individual providing the specimen, and the reason for the collection.

What is the purpose of specimen collection form for?

The purpose of the specimen collection form is to track and document the handling of specimens to ensure accuracy and consistency in testing and analysis.

What information must be reported on specimen collection form for?

Information such as the type of specimen, the date and time of collection, the identity of the individual providing the specimen, and any relevant medical history or conditions must be reported on the specimen collection form.

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