A1c Test
Let the blood spots air-dry for at least 30 minutes.
Make sure specimen is dry
prior to folding Hemoglobin
A1c Test Authorization
Form.
HEMOGLOBIN A1c
COLLECTION
INSTRUCTIONS
Experts in Lab Results by Mail
PLEASE READ THOROUGHLY
Remember to complete all your personal
information on the Hemoglobin A1c Test
Authorization Form. Please read and provide
your signature and date under the Patient
Consent in order to approve your sample for
testing. Heritage Labs will not complete any
testing without your signature and date.
Toll-free ReliOn customer support:
1-888-764-2384
1.
Check The Contents Of Your Kit
Your Appraise kit contains:
1. Collection Instructions
2. Hemoglobin A1c Test Authorization &
Collection Form
3. Lancet
4. Alcohol Pad
5. Gauze Pad
6. Adhesive Bandage
7. Postage Paid Return Envelope
4.
Stimulate Blood Flow
Stimulate blood flow to the selected finger by letting
your hand hang at your side for 15-20 seconds.
Shake your hand back and
forth several times.
3.
Rinse Hands
Rinse hands in warm tap water. Clean the selected
puncture site with an alcohol
pad and dry it with a
gauze pad.
5.
Use The Lancet Provided
Using the lancet provided,
remove the cap, place
palm up and position lancet
on finger. Press down on
lancet to puncture site.
Wipe off the first blood
drop with the alcohol pad.
6.
Blood Should Begin To Flow
Blood should begin to flow freely. Place a large free-
flowing drop of blood on each circle of the Collection
Form as indicated. Do not place one drop of blood on
top of the other. If blood flow stops, wipe with alcohol
pad again to assist blood flow.
7.
Let The Blood Spot Air-Dry
2.
Fill Out The Hemoglobin A1c
Test Authorization Form
Fill out the Hemoglobin A1c Test
Authorization Form and complete
the required information.
9.
Mailing Instructions
Optimal Control
Sub-Optimal Control
Poor Control
Very Poor Control
1. Place the Hemoglobin A1c Test Authorization Form
into the postage paid return envelope.
2. Mail the sample within three days of completion of
the collection.
3. Results will be released to you in
the manner as directed by you on
the Hemoglobin A1c Test
Authorization Form.
CORRECT INCORRECT
A1c Importance
Daily plasma glucose monitoring is important; though
additionally a more long-term picture is necessary in
order to assess the effectiveness of your diabetes treat-
ment plan. The A1c test shows your average plasma
glucose level over a two to three month period. By testing
these levels regularly and using the results, along with
your daily plasma glucose records, you can determine
how well your diabetes is being controlled.
Count on A1c to help
you stay in control
The American Diabetes Association (ADA) recommends
that peo
ple with diabetes monitor glycemic control with
an A1c test every two to three months. Also recom-
mended are an
annual test of microalbumin levels to
verify proper kidney function and a cholesterol test,
including LDL and HDL levels, to help determine whether
you are at risk for heart disease or stroke.
Use only as indicated
The ReliOn
®
collection card is intended to collect blood
for analysis of A1c. The Appraise collection kit is mailed
to Herita g e Lab s fo r ana lysi s and the results are
released to you in the manner and address as directed
by you on the Hemoglobin A1c Test Authorization Form.
Good daily plasma glucose control
makes for good A1c results
People with frequent high plasma glucose readings may have a
high A1c test result.To maintain an A1c level of less than 7%, your
daily plasma glucose should rarely go above 170 mg/dL in any
given two to three month period. Use the chart below to under-
stand how your daily plasma glucose results relate to A1c levels.
Comparing Plasma Glucose with A1c
c1A %Ld/gm ,esoculG egarevA
5001
6531
7071
8502
2 904
01572
11013
21543
Use A1c to help reduce
the risk of complications
A1c is a type of hemoglobin that interacts with plasma glucose.
The A1c test gives you a picture of your average plasma glucose
level over
the previous two to three months and can be used to
predict your risk for complications.
The higher the A1c result, the
higher your risk.
A1c measurements should be a regular part of your diabetes
care.
ReliOn
®
delivers accurate
results without the hassle
With ReliOn
®
, you can collect a sample anytime and anywhere.
What’s more, the accuracy of the ReliOn
®
A1c test averages
98% or more when compared with standardized laboratory
methods using whole blood collected in a tube. As with any lab
test, improper specimen collection may affect results.
Please review your test results with your doctor or health care
professional.
Store and handle your
ReliOn
®
kit properly
The ReliOn
®
collection kit may be stored at room temperature
(65°-78° F). When properly stored, the kit is stable until the
expiration date printed on your ReliOn
®
kit. Do not use the
ReliOn
®
kit past the e xpiration date.
Limitations
As with any laboratory test, there are factors that can affect test
results. Hemoglobin A1c (A1c) values should be used in con-
ju n cti o n wit h informat ion from o t her cli nica l a nd med i cal
evaluat ions. A 1c is not a dia gn osis for dete ct ing diabetes.
Improper collection of specimens may affect laboratory results. If
you have any questions regarding the performance of A1c testing,
please consult your doctor.
A word of warning
Persons with he mophilia or anti-coagulation therapy should
consult their doctor or health care professional prior to using
this kit.
C0488 Rev. 02/19/08
8.
Tear Off Top Portion Of The
Test Authorization Form
Tear off top portion of the Hemoglobin A1c Test
Authorization Form. Retain for your records.Your
specimen number will be necessary to retrieve
results electronically.
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