SAMPLE/TISSUE TRACKING LOG Page ___ of ___Study Title/Acronym:Investigator: Site name/no.:UHL Number: EudraCT no.: IRAS no.:Sample Type: W = Whole Blood P=Plasma S=Serum T= Tissue U= Urine O= Other please specify
Sample processing SOP numbers:
Storage Location (include temperature) :
Subject ID No.
Subject Initials
(if known)
Sample/Tissue ID
Sam
ple
Type
Collection Date(dd/
mmm/yy)
Collection Time (24hr)
Time Sample
Processed (24hr)
Time placed in Storage
(24hr)
Sample Storage Location (inc. shelf/
box/ column/
row)
Staff Initials
Sam
ple
Rem
oved
D
ate
& S
taff
In
itia
ls
Volu
me
of
sam
ple
rem
oved
(i
nclu
de
unit
s)Sa
mpl
e Sh
ippi
ng D
ate
& S
taff
Init
ials
Sam
ple
Des
truc
tion
da
te &
Sta
ff
Init
ials
CommentsInclude any comments on
sample receipt or processing and freeze/thaw
cycles.
Shelf:___
Box: ____
Row:____
Date:
Initials:
Shelf:___
Box: ____
Row:____
Shelf:___
Box: ____
Row:____
Shelf:___
Box: ____
Row:____
Shelf:___
Box: ____
Row:____
Shelf:___
Box: ____
Row:____
Sample Tracking Log V1.0 dated 19Sep19
