Make a Sample Rejection Form and send this to the requester when a sample and/or sample Request Form proves to be unsuitable for examination


When a sample is rejected, the sample rejection procedure of the SOP for Sample Reception and Processing (previous activity) must be followed to ensure that the client is notified and can take action (i.e. send in a new sample). The Sample Rejection Form serves also to get insight in how many samples are on average rejected and for what reasons. This could serve as an indicator for the quality of instructions on sample collection provided by the laboratory to the clients.


Develop a Sample Rejection Form. Include to following elements in the form:

  • Identification of the patient
  • Identification of the sample
  • Identification of the requester
  • Date of sample collection
  • Date of sample reception
  • Reasons for sample rejection
  • Request for sending in a new sample (if still possible)

The African Centre for Integrated Laboratory Training (ACILT) has generously provided a template of a Sample Rejection Form that could be used by TB laboratories. This template can be found in the right-hand column together with another template to show the different posibilities.

How & who

Quality Officer

  1. Develop the form for sample rejection, include above elements.
  2. The form must be made part of the SOP for Sample Reception and Processing by including it as an appendix.
  3. Make a folder "Rejected samples"
  4. Present the form to the staff members working in the sample reception unit and explain why, when, and how this form must be used. Make sure that if a form is send to a requester because a sample was rejected, a copy of the form is made and stored in the folder "Rejected Samples".

Back to Roadmap Activity Overview
This activity belongs to the QSE Process Management
ISO15189:2007: 5.4.8
ISO15189:2012: 5.4.6