Rev F
Biosite Technical Service: 1-877-441-7440 Reviewed by: _____________________________________________________________ Date: ______________________________________
QC Sample Test Log Sheet Used as an alternate method of tracking QC Sample test history.
Month _______________________ Laboratory Name ______________________________________________ Testing Site________________________________________________
A-7
Date/ QC Sample Expiration Analyte Analyte Analyte Analyte Analyte Analyte Analyte Analyte Analyte Analyte Analyte Analyte Analyte Analyte Analyte Tech
Time LOT Number Date Level 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Comments Initials
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Level I Low
Level II High
Level I Low
Level II High
Level I Low
Level II High
Level I Low
Level II High
Level I Low
Level II High
Level I Low
Level II High
Level I Low
Level II High
Level I Low
Level II High
Level I Low
Level II High
Level I Low
Level II High
Level I Low
Level II High
Level I Low
Level II High
Level I Low
Level II High
Level I Low
Level II High
Level I Low
Level II High
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