Measurement Uncertainty Reporting Form template
A qc sheet in the Measurement Uncertainty procedure (PR22), mapped to ISO 15189:2022 clause 7.3.4. Fill it in whenever the task occurs. Used by the laboratory team.
Qc sheetISO 15189 · 7.3.4As needed
Calculated automaticallyRed = outside limits
Your LaboratoryMeasurement Uncertainty Reporting Form | YL-LAB-FRM-22-F01 v1.0
Record: Measurement Uncertainty Reporting Form — October 2026
Test / Analyte (Measurand)Glucose
Instrument / MethodChemistry analyser
Units of MeasurementHaematology
Date of MU Estimation2026-10-01
Estimated byT. Moyo
Reporting Summary
Reported MU (UEXP)
Reported MU as ±
Reporting Format (same units/sig figs as result)43
Inputs used in calculations
URW Level 1 (Low Concentration) · VALUE5.10
URW Level 2 (High Concentration) · VALUE15.02
Sign-off
| Role | Name | Signature | Date |
|---|---|---|---|
| Completed by | |||
| Reviewed by |
Shaded cells are calculated automatically. Values in red are outside their limits. † marks a corrected value (see Corrections).
Controlled document. Printed copies are uncontrolled unless stamped.Page 1
A4 portrait · first page · showing 0 of 0 rowsExactly as LabToolkit Pro prints it — with your logo and colours
What it records
- Test / Analyte (Measurand)
- Instrument / Method
- Units of Measurement
- Date of MU Estimation
- Estimated by
- Reported MU (UEXP)
- Reported MU as ±
- Reporting Format (same units/sig figs as result)
- URW Level 1 (Low Concentration) · VALUE
- URW Level 2 (High Concentration) · VALUE
Sign-off
- Completed by
- Reviewed by
Related templates
Clause references are to ISO 15189:2022; check them against your licensed copy of the standard.