ANSWER SHEET FOR 2013 ACCU-CHEK INFORM II TEST COMPETENCY
Name________________________________ Lawson ID #________________
Date_________________________________
School/Facility Name_______________________Score___________________
Directions: Circle the best answer.
1. a b c d e
2. a b
3. a b c d e
4. a b c d
5. a b c d
6. a b c d
7. a b c d
8. a b c d
9. a b c d
10. a b
11. a b c d e
12. a b c d e
13. a b
14. a b
Instructor’s Name: ___________________________________________________
The undersigned certifies as follows:
I have read the Guidelines of Practice for Point-
of- Care ACCU-CHEK Inform II Blood Glucose
Monitoring System Policy. I understand this test
in of itself does not test competency. This test in
conjunction with a “hands on” demonstration is
needed to certify competency and allowing the
use of the ACCU-CHEK system.
Student Signature
Date
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