HairConfirm Business - The Multi Drug On Site Workplace Drug Test Kit

PLEASE READ FIRST: IMPORTANT MESSAGE TO THE COLLECTOR
We advise that completion of the Custody and Control Form (CCF) and collection of the hair sample is carried out by trained personnel. To become a trained collector, please visit www.hairconfirmbusiness.com to view our hair collection training guide and to complete a questionnaire. Please also ensure to read all instructions on both sides of this sheet before proceeding with the hair collection. A test will be voided if the CCF is not completed correctly and/or the sample is not taken as per the instructions.

If you have any questions please call Customer Service at 1-888-5-CONFIRM.

1. CHECK CUSTODY AND CONTROL FORM
Ensure that the Specimen ID number on the CCF matches the Specimen ID number on the Hair Pouch Seal, which can be found at the bottom of the CCF.

2. IDENTIFY DONOR AND COMPLETE COLLECTION SITE INFORMATION (STEP 1 ON CCF)
Ask the donor to sit and identify them by photo ID. Complete STEP 1 (Collection Site Information, Donor Information and Reason for test) on the CCF. If the donor cannot be properly identified, cancel the hair collection.

3. COLLECT SPECIMEN
Show the donor that the Hair Specimen Pouch is empty and place it in the donor’s view.

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ADDITIONAL MATERIALS REQUIRED FOR HAIR COLLECTION
• Hair clip • Scissors • Ball point pen • Alcohol wipe • Donor’s Photo I.D.

» What is Hair Testing?
» Drug Testing Comparison Sheet
» Cut-off Levels and Response Sheet
» Collector Training Guide
» Collection Questionnaire

I. TAKE THE HAIR SAMPLE
a. Clean the scissors with an alcohol wipe.

b. Slide the hair clip horizontally under the hair at the crown of the head. Lift a 2 inch wide section of hair upwards exposing the base of the hair underneath and clip the hair in place.

c. Using your fingers below the clip, select a long strip of hair, measuring at least 1.5 inches in length, and gently lift it straight
out from the scalp. Slide the scissors down the selected hair sample until they rest flush with the scalp.

Fig. 1

d. Cut the sample as close to the scalp as possible. You must collect 90 to 120 strands of hair (equal to the diameter of a pencil or a soda straw when placed in the Collection Foil). (Fig. 1)

More strands are needed if the hair is less than 1.5 inches long or if the hair is extremely thin. Collect from several locations if hair is very short. (Note: If hair is short, for example only .5 inch, this length will only provide a drug use history of 30 days.)

If the donor’s hair is less than .5 inch long, collect ONLY body hair (e.g. chest, leg, arm, pubic area or underarm). It is important NOT to mix head and body hair. ONLY COLLECT ONE OR THE OTHER.

II. PREPARE THE HAIR SAMPLE FOR SHIPMENT

a. Align the root ends of the hair sample (the ends closest to the scalp) so that they are even. Place the ROOT ENDS against the EDGE of the Collection Foil where it is marked "Place ROOT ENDS HERE". (Fig. 2a)

b. Begin to fold the foil in half starting at the "Place ROOT ENDS HERE" tab. (Fig. 2b)

c. Straighten and hold the hair to full length along the center fold line of the foil keeping the root ends together at the edge of the Collection foil. (Fig. 2c)

d. Fold the Collection Foil in half along the center line and press firmly. (Fig. 2d)

e. Fold the Collection Foil again LENGTHWISE (Fig. 2e) and wrap any excess hair extending beyond the foil around the foil.

Fig. 2a Fig.2b Fig.2c

Fig.2d Fig.2e

THE SAMPLE IS NOW READY TO BE PLACED INTO THE HAIR SPECIMEN POUCH

III. SEAL THE HAIR SAMPLE
Put the Collection Foil with the Hair Sample into the Hair Specimen Pouch with the donor observing, and then seal the Hair Specimen Pouch with the Hair Pouch Seal provided on the CCF.

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4. IDENTIFY HAIR SPECIMEN (STEP 2 ON CCF)
You MUST check EITHER “Head Hair” or “Body” in STEP 2 on the CCF. DO NOT CHECK BOTH.

5. COLLECTOR AND DONOR ANNOTATE SEALS (STEP 3 ON CCF)
Date the Hair Pouch Seal which has been affixed to the Hair Specimen Pouch. Instruct the donor to initial this Seal (Fig. 3). Inform the donor that this indicates the pouch was sealed properly, in the donor's presence, and that the Hair Pouch Seal number and CCF Specimen ID number match.

                                             Fig. 3

6. COLLECTOR INITIATES CERTIFICATION STATEMENT (STEP 4 ON CCF)
Complete the Collector Section in STEP 4 on the CCF.

7. DONOR COMPLETES CERTIFICATION STATEMENT (STEP 5 ON CCF)
Instruct the donor to read the certification statement in Step 5 and sign, print name, date and provide phone numbers and date of birth (optional) after reading the statement (ALL YELLOW SHADED AREAS). If the donor refuses to sign the certification statement, you must provide a remark in Step 2.

8. PREPARE SAMPLE AND CCF FOR SHIPMENT
Fax the white copy of the CCF to the Medical Review Officer using the fax number on the CCF. Then place the sealed Hair Specimen Pouch into the small pouch of the clear Specimen Bag and place the white copy of the CCF into the large pouch of the Specimen Bag. Seal the bag. (Fig. 4)

Place the Specimen Bag into the pre-paid envelope provided. Distribute the remaining copies of the CCF.

Fig. 4

9. REGISTER TEST
Results are available online. You must register your test using the Specimen ID number and Passcode found on the CCF. Select to receive email notifications and we will email you when your results are ready.