Biospecimen Collection Instructions

Thank you again for your participation! If you have any questions, feel free to: Email us: [email protected] Call us: (617) 903-0NHS (617-903-0647) For answers to frequently asked questions, visit our website at http://www.nhs2.org/blood Our office hours are Monday through Friday, EST 8:00A.M. - 5:00P.M. We remain on call during off hours and make our best effort to respond to urgent calls within the same business day. Please leave a voicemail. If at any point you decide not to participate, please call us before discarding your kit.

 Please plan to collect and ship your samples Monday through Thursday. Our capability to receive and process samples on Saturdays and Sundays is limited. Please also note: FedEx does not pick up on Saturday, Sunday, or national holidays.

 If you need to collect and ship your samples on Friday: Call us at least a week in advance. We need to mail you a new FedEx airway bill.

 If you need to collect your samples during the weekend: Put the sample in the refrigerator (do not freeze) and send it on Monday morning. If you do this, include a note with your samples so we are aware of the weekend draw date.

To confirm that you are willing to participate in the study: We have provided two copies of the Research Consent Form. This form explains the procedures involved in the study, potential risks and benefits to you, and information about confidentiality. It is essential that you sign and date the consent statement at the end of the blue consent form and return the entire form with your samples. Keep the white copy, which is attached to this instruction packet, for your own records.

1-2 days before you plan to have your blood drawn: CALL PHLEBOTOMIST If you are having your blood drawn at a lab or doctor’s office, call ahead of time to confirm that they will draw blood for someone in a research study. Community health centers may be willing to do the draw; you may search for your local center at the website http://findahealthcenter.hrsa.gov/ It is fine if the lab uses its own supplies, but ensure that they use green-top, sodium heparin tubes. FREEZE GEL PACK Put the refrigerant gel pack into the freezer overnight. CALL FEDEX Call FedEx to arrange for FedEx pickup. They can pick up from your home or work. Call 1-800463-3339 (1-800-GO-FEDEX) and dial 0 to speak with an operator. Tell the operator that you are shipping via Priority Overnight method using a billable stamp and give them the address where you would like the pick-up to be made. You may also drop off your parcel at a manned FedEx location, which can be found by calling FedEx or visiting http://www.fedex.com. You do not need to make prior arrangements to drop off your samples. 1

Time of day to collect samples: Although not essential, we would prefer you to have your blood drawn in the morning before you eat or drink (you can drink water). It is also most beneficial if your urine sample is a first morning void. If you forget to collect a first-morning urine, a sample collected later in the day also is valuable.

On the day of blood draw and shipment:

URINE COLLECTION The morning you are having your blood drawn: 1. COLLECT FIRST MORNING URINE SAMPLE Use the enclosed plastic specimen cup. Use the Castile towelette to wash before collecting the sample. 2. TRANSFER AND STORE URINE Using the pipette, transfer the urine from the collection cup into the smaller urine tube up to the line marked 20ML. Once the holder is full, recap it and place it upright (e.g. in a cup) in the refrigerator until you are ready to have the blood sample drawn. 3. DISCARD EXTRA URINE Discard the extra urine, the pipette, and the collection cup once you are done filling the urine tube.

BLOOD DRAW When you go to get your blood drawn: 4. TAKE SUPPLIES Put the frozen refrigerant pack into the Styrofoam box and bring the entire brown cardboard box with you when you go to have your blood drawn. If you are planning to ship immediately after having your blood drawn, also take your urine. 5. It is important that your blood is collected in green-top sodium heparin tubes. 6. BLOOD DRAW All supplies needed to draw your blood samples are in the plastic bag in your kit. To use the butterfly needle, remove the clear cap. Once the needle is in the vein, push a green-top tube into the clear needle holder until the tube stopper is punctured and blood starts to flow. Once the tube is full, remove it carefully, and gently insert the 2nd green-top tube into the holder. Repeat this for the third tube. Immediately after filling each tube, invert it 10-12 times to prevent the blood from clotting. We have included one extra tube in case one breaks. 2

7. PACK UP BLOOD TUBES Place the tubes into the white 4-pocket tube sleeve and put the sleeve back into the clear plastic zipper bag. All other contents in the blood bag will have been used during the blood draw. Place the tubes in your Styrofoam box to keep them cool until you are ready to finish packing your kit. Be careful not to let the tubes touch the gel pack directly. If you are charged for the blood draw, have the laboratory bill the Nurses’ Health Study II directly using the reimbursement form included in the kit, or send us a copy of your paid bill for reimbursement using the same form. Please remember to include the receipt. Most charges for blood draw services range from $5-$30.

PREPARING SAMPLES FOR SHIPMENT: Once you have collected both a blood and a urine sample, pack your kit for shipping.

1. Sign and date the blue consent form if you haven’t done so already. 2. Complete the blood collection questionnaire. 3. Place the questionnaire and the blue consent form into the white envelope and seal. 4. If you have not done so already, place the 4-pocket tube sleeve holding your blood tubes into the clear plastic zipper bag. Also place your container of urine into the plastic bag. Seal the bag. 5. Place the bag from step 4 into the Biohazard bag. Seal it.

6. Wrap the packed Biohazard bag with the bubble wrap cushion sheet.

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7. Place the packed bag from step 6 into the insulated Styrofoam shipping box on top of the gel pack. Close the Styrofoam lid. 8. Place the envelope containing the questionnaire and consent form on top of the Styrofoam lid. 9. Seal the white mailing box closed. 10. Adhere the Exempt Human Sticker to the outside of the box. 11. Write your name and address on the blank lines of the prepaid FedEx airway bill. Other fields have already been filled in. Adhere the airway bill to the box. 12. Give the package to the FedEx driver if you have arranged for a pickup, or drop it off at a FedEx location. FedEx has approved this packaging for the shipment of blood and urine.

CHECKLIST:  Plan to collect and send samples on Monday – Thursday. (page 1)  Review and sign the blue copy of the Research Consent Form (page 1)  Call the lab or doctor’s office where you will have your blood drawn to confirm they will draw blood for a research study (page 1)  Call FedEx (1-800-463-3339) to arrange for package pick-up the day before collection (page 1)  Put the refrigerant gel back in the freezer the day before collection (page 1)  Collect urine sample from first morning void on same day as blood draw (page 2)  Bring all supplies and urine with you to the blood draw. Draw 3 green-top tubes of blood (page 2)  Complete the questionnaire (page 3)  Pack the white insulated shipping box for return shipment (page 3 & 4)

IF YOU HAVE ANY QUESTIONS OR NEED MORE SUPPLIES, E-mail us at or call us at

[email protected] (617) 903-0NHS (617-903-0647)

Again, for answers to frequently asked questions, visit our website at http://www.nhs2.org/blood THANK YOU!

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