IDI Sample Record Destruction Form
IDI Sample Record Destruction Form
IDI Sample Record Destruction Form
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<strong>Sample</strong> DetailsType of<strong>Sample</strong>(blood,plasma,urine,etc)Numberof<strong>Sample</strong>s(total # ofsamples)DescriptionMethod ofdisposal/destruction(specify any important handlinginstructions; if samplesdestroyed by third-party,indicate)If required, attach a list (e.g manifest, Excel sheet) of all individual samples to bedestroyedResearch Office ApprovalBased upon the information provided above, the samples can be destroyed.yesnoIf NO provide reason:Name:Signature:Position:Date:<strong>IDI</strong> <strong>Sample</strong>s <strong>Destruction</strong> <strong>Form</strong> v1 P a g e | 2
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