Phlebotomy Skills Checklist

This profile is for use by healthcare professionals in this discipline and specialty. It will not be a determining factor for the program.
  • Please enter your full legal name as it appears on your Social Security Card.
  • For the next few sections use the following key:

    1. No theory and/or experience
    2. Limited experience/need supervision and/or support
    3. Experienced/minimal support needed to perform
    4. Proficient/can perform independently
  • Theory & Principles Relate to:

  • Principles Related to Safety


  • Knowledge of Appropriate Blood Tubes:

  • Accurately Identify (ID) Patients

  • Procedure

  • Special Populations

  • Pediatric Phlebotomy Procedures

  • Evaluate Lab Data

  • Complications

  • Urinalysis & Body Fluids

  • EMR

  • Please read and agree to the statements below by marking the checkbox.

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