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URINALYSIS REPORT AT INTAKE (TCU OUTPATIENT FORMS) FORM 204; CARD 01 #: SITE CLIENT ID#: DATE URINE COLLECTED: 6 COUNSELOR ID#: 710 MO DAY YR 1. Was urine positive for 1 or more illegal.

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How to fill out the Printable Urinalysis Form online

Filling out the Printable Urinalysis Form online can streamline the process of documenting urinalysis results efficiently and accurately. This guide will provide you with clear instructions on how to complete each section of the form to ensure that all necessary information is captured appropriately.

Follow the steps to complete the Printable Urinalysis Form online

  1. Press the ‘Get Form’ button to access the Printable Urinalysis Form, which you can then open in your chosen editor.
  2. Begin by entering the site name in the designated section. Ensure accuracy as this identifies where the collection took place.
  3. Provide your Client ID number in the specified field to link the results to the correct individual.
  4. Record the date when the urine sample was collected using the fields labeled for month, day, and year. It is essential to make this entry clear for future reference.
  5. Input your Counselor ID number in the appropriate field to confirm who is overseeing the analysis.
  6. Indicate whether the urine tested positive for one or more illegal drugs by selecting '0' for No or '1' for Yes in the provided section.
  7. If the result was positive, respond to the subsequent questions regarding specific substances by marking Yes or No for each drug listed, including opiates, , sedatives/barbiturates, benzodiazepines, amphetamines, cocaine/crack, THC, PCP, and .
  8. If there are any other substances that should be noted, use the space provided to specify those drugs.
  9. Once all fields are filled out accurately, review your information to ensure completeness and correctness.
  10. Save any changes you have made to the form, and choose to download, print, or share the form as needed.

Complete your Printable Urinalysis Form online today!

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Normal values are as follows: Color – Yellow (light/pale to dark/deep amber) Clarity/turbidity – Clear or cloudy. pH – 4.5-8. Specific gravity – 1.005-1.025. Glucose - ≤130 mg/d. Ketones – None. Nitrites – Negative. Leukocyte esterase – Negative.

Physical characteristics that can be applied to urine include color, turbidity (transparency), smell (odor), pH (acidity – alkalinity) and density. Many of these characteristics are notable and identifiable by by vision alone, but some require laboratory testing.

Urine is typically clear. Cloudiness or an unusual odor can indicate a problem, such as an infection. Protein in urine can make it appear foamy. Blood in the urine can make it look red or brown.

During a urinalysis, a clean urine sample is collected into a specimen cup and analyzed with a visual exam, a dipstick test, and a microscopic exam. The presence of cells, bacteria, and other chemicals is detected and measured in a urinalysis.

Documenting the urinalysis results in the notes Document the time and date that the urinalysis was performed (as this may be significantly different from the time you are documenting). Write the indication for the urinalysis (e.g. dysuria). Inspect the urine and document the following characteristics of the urine:

Document: the date and time. the type of urine specimen. any observations regarding the quantity and quality of urine.

Nitrite urine test: A positive nitrite test result can indicate a urinary tract infection (UTI).

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