Practice prep collection form - Baystate Health 2026

1. Click ‘Get Form’ to open the Practice prep collection form in the editor.
2. Begin by entering the Man’s Full Name and Date of Birth at the top of the form. This information is crucial for identification purposes.
3. Next, fill in the Woman’s Full Name and Date of Birth. Ensure accuracy as this data may be referenced during processing.
4. Record the Date and Time of Collection. This helps in tracking and managing your specimen effectively.
5. Indicate the Number of days since last ejaculation, and select the Method of Collection by checking the appropriate box.
6. If applicable, specify any Lubricant Used, including options like None or Pre-Seed, or write another type if used.
7. Answer questions regarding specimen loss during collection and any transportation problems encountered.
8. List any medications you are taking in the designated section to provide complete medical context.
9. Finally, confirm whether this is a post-vasectomy or post vasectomy reversal specimen by checking Yes or No.
10. Sign and date at the bottom to certify that all information provided is accurate before submitting your form.

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