Purdue University
Veterinary Technology Distance Learning Program
School of Veterinary Medicine, 625 Harrison Street, West Lafayette, Indiana 47907-2026
Clinical Mentorship Site Facility
Requirement Agreement – VM 22700
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Microscope*:
Requirements: Minimum Functional criteria suitable for hematology,
urinalysis and other cytology:
1. 10X oculars
2. Objectives: ~4-5X (scanning) (optional)
10X (low power)
40-50X (high dry)
100X (oil immersion)
3. Mechanical stage
4. Functional and properly aligned condenser and diaphragm
5. Light source of ≥ 20 watts
6. Lens paper
7. Lens cleaning solution
8. Suitable for hematology, urinalysis, and other cytology
9. All parts clean, functional, properly adjusted and aligned
10. Binocular
Make and Model of Microscope (Specify): ____________________________
*NOTE: We highly recommend, if the microscope has not been professionally
serviced within the last six (6) months and/or is in a questionable state of repair, it be
professionally serviced.
Microscopes which are in a state of disrepair, out of adjustment, or dirty
internally or externally will create difficulties for the student in providing accurate results.
If there is any question of the suitability of the microscope for hematology,
cytology, urinalysis, microbiology and parasitology, service personnel will usually be
able to assist you in determining appropriateness.
Because of the great variability in the quality of microscopes, some scopes
seemingly meeting these minimum criteria may not be suitable for this mentorship.
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Hematology Supplies and Instrumentation
 Hemocytometer with hemocytometer coverslip
 Platelet/WBC Unopette
 Automated Hematology Analyzer w/appropriate supplies and capable of
providing:
Red Blood Cell Counts
White Blood Cell Counts
Platelet Counts
Hematocrit
Hemoglobin**
Make and Model of Analyzer (Specify): ____________________________
 Hemoglobin Analyzer**
Make and Model of Analyzer (Specify): ___________________________
 Microhematocrit (PCV) Centrifuge
 Microhematocrit (PCV) Tubes (Plain)
 Microhematocrit (PCV) Tube Sealer (Clay)
 Microhematocrit (PCV) Reader
 Refractometer (Clinical— Total Protein and Specific Gravity Scales)
 Frosted End Glass Slides
 Stains
 Quick Stain (ex. Diff-Quik) and
 New Methylene Blue
 EDTA Blood Collection Tubes (Appropriate for the size of the patient)
 Petri Dish
 Laboratory Wipes
 Small Test Tube
 #2 Pencil
 Extra Fine Black Permanent Marker
 Hand Tally Counter (Single Digit and/or Multi-Key (optional)
 Microscope (see above)
(**NOTE: This may be a stand alone instrument manual or automated instrument or a
function of an automated hematology or chemistry analyzer)
Urinalysis
 Centrifuge appropriate for the centrifuge tubes
 Centrifuge Tubes
 Urine Chemistry Test Strips (Minimum Tests: pH, Glucose, Ketones, Bilirubin,
Blood, Protein)
 Frosted End Glass Slides
 Coverslips
 Stain (Optional) (New Methylene Blue or Sedi [Type])-Stain)
 Disposable Pipettes
 Microscope (see above)
 Refractometer (Clinical—Total Protein and Specific Gravity Scales)
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 Test Tube Rack
Clinical Chemistry
 Automated Chemistry Analyzer w/appropriate supplies
Make and Model of Analyzer (Specify): ____________________________
 Clot (Plain Red Top) Blood Collection Tubes appropriate for the size of the
patient
 Serum or Plasma Separator Blood Collection Tubes appropriate for the size
of the patient
 Anticoagulated Blood Collection Tubes appropriate for the size of the patient,
specific tests and brand of automated chemistry analyzer
 Centrifuge appropriate for the serum and plasma blood collection tubes
Serology
 Two (2) Tests, using at least Two (2) Different Formats/Methods (Formats include
but are not limited to: ICT Gold, Rapid Slide Agglutination, Lateral Flow Immune
Assay, Latex Agglutination, Tube Precipitation, Radial Immuno-Diffusion,
Immunochromatographic, etc.). Note: Two of the same formats, for two different
tests does not constitute two different formats (ex. A SNAP for HW and SNAP for
FeLV does NOT constitute two different formats/methods).
Specify a minimum of two (2) available tests that meet these criteria:
Test
ex. K-9 Brucellosis
FeLV Antigen
Heart Worm
Brand
Synbiotics
Idexx
Heska
Format (Method)
D-Tec-CB/Rapid Slide Agglutination
SNAP/ELISA/Lateral Flow Immune Assay
SoloStep/ELISA/Lateral Flow Immune Assay
1. _____________ __________
___________________________________
2. _____________ __________
___________________________________
Cytology
 Refractometer (Clinical—Total Protein and Specific Gravity Scale)
 5-6” Sterile Cotton Tip Swab
Stain:
 Quick Stain (ex. Diff-Quik) and
 Gram Stain
 Frosted End Glass Slides
 Sterile Saline
 Vaginal Speculum (appropriate for the patient)
 Microscope Binocular (see above)
 Laboratory Wipes
Syringe and Needles appropriate for the aspiration procedure
 WBC Unopette for cell counts for fluid aspirants
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Coagulation Tests
 Equipment, Supplies and Materials to perform two (2) of the following tests
(Designate which two (2) will be performed):
 Buccal Bleeding Time
 Lancet
 Timer
 Filter/Blotting Paper
 Activated Clotting Time (ACT) (Specify: Automated or ACT Tube Test)
 Prothrombin Time (PT)
 Partial Thromboplastin Time (PTT)
 Fibrinogen Assay (Specify: Automated or Heat Precipitation)
 Other (Specify Test: ________________ Method: _______________
Patient Types
 Two (2) or more species of mammals
 Two (2) or more female dogs in varying stages of estrus for vaginal cytology.
 One (1) or more species of non-mammal
I certify that the veterinary care facility _______________________________
Name of Veterinary Hospital or Facility
Has the equipment that I have indicated by checking the boxes above; and that such
Equipment and materials are available to the VT-DLP Student ___________________
Name of Student
for use in the completion of the VM 22700 Clinical Mentorship.
I certify that this facility is in compliance with current OSHA (Occupational Safety
and Health Administration) and any state or local regulations, requirements, or
laws regarding workplace safety.
Printed Name of Facility Veterinarian: ___________________________________
Signature: ___________________________________
Date:
___________________________________
This form must be signed and returned to the student, submitted and approved by Purdue prior to beginning of the clinical
Mentorship VM 22700.
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