Patient Name: ____________________________________ Patient # : ____________________________________
(1). Choose an appropriate day on which a 24 hour urine sample can be collected without interruption.
(2). Upon awakening, completely void and discard the first specimen of urine.
DO NOT collect this sample in the container. This will represent the initial emptying of the bladder at which time the start of the collection will be recorded.
Record “Start” Time: ____________________________________ Date: ____________________________________
(3). Collect ALL urine samples (within a timed 24-hour period) into the urine specimen container provided. Absolutely no urine is discarded at this point. Preserve urine by placing the container in a refrigerator.
(4). Regular meals and fluid intake can be consumed during the 24-hour collection period.
(5). Approaching the end of the 24-hour, collect the last urine specimen into the container. This will represent the final emptying of the bladder at which time the end of the collection will be recorded.
Record “End” Time: ____________________________________ Date: ____________________________________
Note: if the “End” time is after awakening the following morning, then collect that first morning sample into the container and record the time.
For lab use only:
Total volume of urine collected (mL) _____________________________________________________________
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