Employee Information  Agency staff, please use your assigned 4 digit ID. Core staff must use UTMB employee ID
EMP/STUDENT ID	First	Last
Workplace  Using the appropriate selection box below, please select your area of workplace. Note: TDC, Agency, and Medical Students may be selected using the Hospital Service selection box.
UTMB Clinics                                 --- SELECT SITE --- CSB 4 - Endoscopy --- UHC --- (select site) UHC 3 - Ob/Gyn UHC 4 - Cardiac Rehab UHC 4 - Chronic Home Dialysis UHC 4 - Echo UHC 4 - Galv Fam Med UHC 4 - Int. Med/Harborside Med Grp UHC 4 - Stark Diabetes UHC 5 - Dermatology UHC 5 - Medicine Specialties UHC 5 - Oral Surgery UHC 5 - PT/OT UHC 5 - Surgery Specialties UHC 7 - Pedi Specialties UHC 7 - Island Pediatrics UHC 7 - Galveston RMCHP ---OTHERS--- Aviation Medicine Emergency Room Stark Diabetes - UEC Student Wellness Telemedicine Electrophysiology Lab UTMB Radiology  Community Based Clinics         ---SELECT SITE--- Cancer Center - Dickinson Clinic Clear Lake Pedi Specialty Derm & GI - Dickinson Island Pedi Urgent Care Ctr Mainland Med Spec - Texas City MedSurg Spec - Friendswood Neuro & Pain Mgmt - Friendswood Pedi Assoc - Alvin Pedi Assoc FHC - Friendswood Pedi Assoc FHC - League City Pedi Assoc - Texas City Pedi Urgent Care - South Shore Radiology Center - Friendswood Radiology Specialty Procedures Stewart Road FHC Texas City FHC Texas City Geriatrics Oceanview Women's Hlth & Univ Fertility Ctr Other  RMCHP & WIC Clinics                 --- SELECT SITE --- *ADMINISTRATIVE* ANGLETON BEAUMONT BIRTH CENTER CONROE DICKINSON GALVESTON PCP HUNSTVILLE KATY LIVINGSTON MCALLEN NACGADOCHES NEW CANEY ORANGE PASADENA PEARLAND PRAIRE VIEW STAFFORD TEXAS CITY VICTORIA WHARTON other  Hospital  Service                           -----SELECT SITE----- Austin Women's Hospital **** John Sealy Annex **** OR - PACU OR HOLDING ***JS Towers (select one)*** J2A/B/C L&D J2D - BICU J3A/B - Ante-Partum J3C - Newborn Nsy J3D - ISCU J4A - SICU J4B - MICU/CCU J4C/D - Cardiac Cath Lab J5A/B -GCRC J6C/D Ante/Post Partum J7D - Med/Surg J8A - Day Surgery J8B - Dialysis J8C/D - Ante/Post Partum J9D - Transplant J10A - Pedi J10C/D - ACE Unit ---TDCJ (Select One) --- TDC 6A - Day Surg TDC 6B - Surgery TDC 6C - Women's TDC 7A - Telemetry TDC 7B - Med ***MISC*** MEDICAL STUDENT RESIDENT ER/ FAST TRACK ENDOSCOPY OTHER
I have read the pH Policy and Procedure  Yes		Click on START TEST to begin

Test Date:

START TEST

 

 

  

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

	1. The proper control material that must be used in order to check the accuracy of pH paper include: Accudata control solutions Quantimetrix UA control solutions DI water and saline acidic developer and a preservative solution (Sodium Azide)
	2. Specimens must be tested within_____ minutes after collection 2 to 5 10 to 15 30 to 45 30 seconds
	3. The quality control frequency as established and outlined in the pH policy and procedure is set at: once per month with new open kit or lot each day of patient testing all of the above but whichever is less
	4. Light (whether natural or fluorescent) deteriorates the internal components of the paper resulting in inaccurate patient results. TRUE FALSE
	5. Bloody specimens are unacceptable for testing TRUE FALSE
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