Sample Requirements, Transport Systems and Method Review Form template
A form in the Pre-examination and Sample Handling procedure (PR20), mapped to ISO 15189:2022 clause 7.2. Fill it in whenever the task occurs. Used by the laboratory team.
FormISO 15189 · 7.2As needed
Calculated automaticallyRed = outside limits
Your LaboratorySample Requirements, Transport Systems and Method Review Form | YL-LAB-FRM-20-F06 v1.0
Record: Sample Requirements, Transport Systems and Method Review Form — October 2026
Review periodOctober 2026
SectionHaematology
Reviewed byS. Dlamini
Periodically review whether sample type, volume, container, stability and transport arrangements are still adequate, using rejection data, turnaround times, EQA and user feedback. Update the User Handbook when requirements change.
| No. | Examination | Sample type / container / volume | Stability & transport conditions | Evidence reviewed | Adequate? | Change required / action | Responsible / due |
|---|---|---|---|---|---|---|---|
| 1 | Glucose | S. Dlamini | Yes | None required | 2026-10-01 | ||
| 2 | Creatinine | A. Mensah | Yes | None required | 2026-10-08 | ||
| 3 | ALT | L. Banda | Yes | None required | 2026-10-15 | ||
| 4 | Haemoglobin | K. Otieno | No | Investigated and repeated: within limits | 2026-10-22 | ||
| 5 | Potassium | T. Moyo | Yes | None required | 2026-10-29 | ||
| 6 | Glucose | R. Naidoo | Yes | None required | 2026-11-05 | ||
| 7 | Creatinine | S. Dlamini | Yes | None required | 2026-11-12 | ||
| 8 | ALT | A. Mensah | Yes | None required | 2026-11-19 |
Sign-off
| Role | Name | Signature | Date |
|---|---|---|---|
| Reviewed by (Section Head) | |||
| Approved by (Laboratory Manager) |
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
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What it records
- Examination
- Sample type / container / volume
- Stability & transport conditions
- Evidence reviewed
- Adequate?
- Change required / action
- Responsible / due
Instructions on the form
- Periodically review whether sample type, volume, container, stability and transport arrangements are still adequate, using rejection data, turnaround times, EQA and user feedback. Update the User Handbook when requirements change.
Sign-off
- Reviewed by (Section Head)
- Approved by (Laboratory Manager)
Related templates
- Specimen Acceptance Criteria (reference Card) (PR20-F01)
- Sample Rejection Log (PR20-F02)
- Oral Request Form (PR20-F03)
- Sample Acceptance Exceptions Log (PR20-F04)
- Sample Retention Schedule (PR20-F05)
- Guide: ISO 15189 documentation checklist
Clause references are to ISO 15189:2022; check them against your licensed copy of the standard.