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Certificate of Training
for Fingerstick Blood Collection
I, Dr. , certify that
possesses the necessary skills and competencies to perform skin puncture for fingerstick blood collection.
This person has properly demonstrated to me fingerstick blood collection in accordance with currently accepted
laboratory standards and protocols. Proper knowledge of the disposal of biohazardous material and industrial safety has
been observed and comprehended for subsequent health events.
Authorization herein is limited to any nondiagnostic health program for general health assessment and does not include
venipuncture, arterial puncture or any other procedure for obtaining a blood specimen.
Date
Physician’s Name
DEA No.
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