Glucometer Attestation


I have reviewed laboratory policies;

20.04.01 Ancillary Department Testing
20.04.02 Ancillary Department Testing Hours
20.04.03 Specimen Collection and Handling
20.04.05 Abbott Precision Xceed Pro Patient Testing
20.04.06 Documentation of Blood Glucose Results
20.04.07 Abbott Precision Xceed Pro Critical Values
20.04.08 Abbott Precision Xceed Pro Quality Control
20.04.09 AccuChek GTS/Plus Linearity Testing
20.04.10 Abbott Precision Xceed Pro Proficiency Testing
20.04.12 Abbott Precision Xceed Pro Competency Assessment
20.04.13 Abbott Precision Xceed Pro Instrument Cleaning


I have read and understand these policies and agree to follow the instructions outlined
within. I will not deviate from the policy without express written authorization from the
Laboratory Medical Director or his authorized representative. I have been provided the
opportunity to have all of my questions answered and have no further questions.
I request further training

I have run QC within the past 30 days
I have not run QC within the past 30 days.

Low Result:
High Result:
Strip Lot#:
Expiration Date:

Employee Number:
Date:

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