9a RECEIPT OF TEST ARTICLE SITE: PROTOCOL NO.: ___________________ INVESTIGATOR: TO BE COMPLETED BY SUPPLY SOURCE NAME OF SUPPLIER: LABEL DESCRIPTION UNIT QUANTITY INITIALS CODE NO. SIZE TO BE COMPLETED BY SITE LABEL LOT/LABEL DESCRIPTION UNIT QUANTITY INITIALS CODE NO. SIZE 1. Was/were test article(s) received undamaged? Yes No 2. Has the shipment temperature appeared to have been maintained? Yes No 3. Was a temperature monitor included in the shipment? Yes No 4. If was the temperature monitor readable at the site? Yes No “Yes,” 5. If what was the readout? Min.____ Max.___ “Yes,” I HEREBY ACKNOWLEDGE THAT THE TEST ARTICLES LISTED WERE RECEIVED ON ________________________________ AT _____________ AM/PM (MM/DD/YY) SIGNATURE
9a RECEIPT OF TEST ARTICLE SITE: PROTOCOL NO.: ___________________ INVESTIGATOR: TO BE COMPLETED BY SUPPLY SOURCE NAME OF SUPPLIER: LABEL CODE NO. DESCRIPTION UNIT SIZE QUANTITY INITIALS TO BE COMPLETED BY SITE LABEL CODE LOT/LABEL NO. DESCRIPTION UNIT SIZE QUANTITY INITIALS 1. Was/were test article(s) received undamaged? Yes No 2. Has the shipment temperature appeared to have been maintained? Yes No 3. Was a temperature monitor included in the shipment? Yes No 4. If “Yes,” was the temperature monitor readable at the site? Yes No 5. If “Yes,” what was the readout? Min.____ Max.___ I HEREBY ACKNOWLEDGE THAT THE TEST ARTICLES LISTED WERE RECEIVED ON ________________________________ AT _____________ AM/PM (MM/DD/YY) SIGNATURE
Regulatory%20Document%20Guidelines.docx