The Collection of Standard Forms

Note: Listed below are the standard testing forms; they are in MS word format. If your browser cannot open these forms, right click on the one(s) you want to see and save the file(s) to disk. Then open them in Word for Windows, version 6.0 or later.
Form 1 Proficiency Testing (PT) Survey Listing & Participation Summary
Form 2 Proficiency Testing (PT) Processing, Enrollment, and Testing of Samples: Flow Cytometry
Form 3 Remedial Action: Unacceptable Proficiency Testing Results, Flow Cytometry
Form 4 Quality Assurance Review: Evaluation of Corrective Actions on Unsatisfactory Proficiency Testing Results
Form 5a Cytometry Equipment and Function Checks
Form 5b Laboratory Equipment and Function Checks
Form 5c Corrective Action: Preventive Maintenance and Function Checks
Form 5d Equipment Service Log
Form 6 Pipette Calibration
Form 7 Adequacy of Methods/Equipment/Instruments for Testing
Form 8 Quality Control
Form 9 Remedial Action: Test Results Reported in Error

Quality Assurance Review Forms

Form 10 Criteria for Specimen Collection and Handling
Form 11 Evaluation of Criteria for Specimen Rejection
Form 12 Completeness of Information on Requisitions and Reports
Form 13 Quality Assurance for Quality Control Corrective Action
Form 14 Relationship between Test Results Using Different Methods, Instruments, or Testing Sites
Form 15 Evaluation of Patient Test Results Inconsistent with Patient Criteria
Form 16 Employee Qualification Documentation
Form 17 Employee Competence Review–Flow Cytometry
Form 18 Documentation of Complaints and Problems Reported to Laboratory
Form 19 Quality Assurance Review with Staff


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CD-ROM Vol 3 was produced by Monica M. Shively and other staff at the Purdue University Cytometry Laboratories and distributed free of charge as an educational service to the cytometry community. If you have any comments please direct them to Dr. J. Paul Robinson, Professor & Director, PUCL, Purdue University, West Lafayette, IN 47907. Phone:(765) 494-0757; FAX (765) 494-0517; Web http://www.cyto.purdue.edu, EMAIL cdrom3@flowcyt.cyto.purdue.edu