Evidence and Specimen Chain-of-Custody Log

Facility/Organization: [Facility/Organization]

Department/Unit: [Department/Unit]

Log Initiated: [Date] [Time] [Time Zone] — [Initiating staff member name/role/ID]

Page: [Page number if paper form]

Documentation Principles:

• No gaps — every custody change recorded chronologically
• No inference — document only what was directly observed and performed
• Contemporaneous entries — document in real time or as soon as practicable; clearly mark late entries with rationale
• Unique identifiers — every item and container uniquely and consistently labeled
• Integrity checks — assess and document condition and seal integrity at each transfer and at every opening/resealing event

Case Identifiers

Healthcare Encounter ID / MRN: [Identifier or "Unknown"]

Law Enforcement Agency and Case Number: [Agency name] — [Case number or "Unknown"]

ME/Coroner Case Number: [Number or "N/A"]

Autopsy Number: [Number or "N/A"]

Sexual Assault Kit Number/Barcode: [Number/Barcode or authorized anonymous ID]

Laboratory Accession Number(s): [List or "Pending" / "Unknown"]

Subject Identification

Subject: [Name or "Unknown/Unidentified"] — [DOB or "Unknown"] — [MRN (patients) / ME-Coroner ID tag (decedents) / Body bag ID (if applicable) / Authorized anonymous identifier]

(If unidentified, record the assigned temporary ID and the method used to assign it. Use explicit placeholders for missing information; do not leave blanks.)

Authority and Consent

(Document the legal basis for collection, retention, transfer, and release. Check all that apply and specify details.)

• Patient consent for collection: [Yes / No] — [Details: date/time, person obtaining consent, scope/limitations]
• Patient consent for release to law enforcement/crime lab: [Yes / No] — [Details: date/time, scope/limitations]
• Warrant/Subpoena/Court order: [Order type and identifier] — [Issuing jurisdiction] — [Date/time served] — [Scope/limitations]
• ME/Coroner statutory authority: [Citation/reference] — [Details/limitations]
• Institutional policy pathway: [Policy title/ID] — [Details/limitations]
• Restrictions or limitations on handling: [Description or "None stated"]
• Authority unclear—do not transfer: [Yes / No] — [Supervisor/legal liaison consulted: name/role/ID] — [Date/time] — [Guidance received]

Evidence Inventory

(One row per item collected. For kit-level workflows, list the sealed kit as its own item. Never leave identity-critical fields blank—use "Unknown" and create a discrepancy entry.)

Item #	Item ID/Barcode	Item Type	Description	Source/Origin & Collection Method	Collector Name/Role/ID	Collection Date/Time/Location	Packaging & Label Elements	Seal Type & Number	Initial Seal Applied By (Date/Time)	Initial Storage Location & Temperature Condition
[Sequential number]	[Item ID/Barcode]	[Biological swab / Blood tube / Clothing / Projectile / Trace evidence / Digital media / Sealed kit / Other]	[Plain-language description; for specimens include matrix, volume, preservative, container]	[Source/Origin] — [Collection method]	[Name] — [Role] — [ID]	[Date/Time with time zone] — [Location]	[Packaging type; label elements present]	[Seal type] — [Seal number]	[Name/ID] — [Date/Time]	[Storage location ID] — [Temperature condition]

Container and Seal Tracking

(Use for sealed containers such as kit boxes, toxicology kits, evidence boxes, body bags, sealed bags. Track condition and seal status at each custody step.)

Container Type & Unique ID	Seal Type & Number(s)	Sealed By (Name/ID)	Date/Time & Method	Condition at Custody Steps
[Container type] — [Unique ID]	[Seal type] — [Seal number(s)]	[Name/ID]	[Date/Time] — [Method: signature/initials across seal]	[Seal intact / Seal broken / Seal replaced] (Reference custody event # or date/time)

Seal Break/Open and Reseal Events

(Document each opening event.)

Container ID	Opened By (Name/ID)	Date/Time Opened	Reason for Opening	Items Removed/Added (by Item #)	New Seal Number	Resealed By (Name/ID) & Date/Time	Notes
[Container ID]	[Name/ID]	[Date/Time]	[Reason]	[Item #s removed/added]	[New seal number]	[Name/ID] — [Date/Time]	[Notes, e.g., seal number unknown/unreadable; photographed per policy]

Chain-of-Custody Transfer Log

(Each row represents a custody event, including placement into and retrieval from storage within the same facility. Both releasing and receiving parties must complete each entry. If a recipient refuses or is unavailable to sign, document this and notify a supervisor per policy.)

Date/Time Released (Time Zone)	Released By (Printed name, signature, role, ID)	Date/Time Received	Received By (Printed name, signature, role, agency/facility, ID)	Items Involved	Purpose of Transfer	From Location → To Location	Seal Status at Handoff	Packaging Condition	Temperature Condition	Courier/Agency	Tracking Number	Shipping Container Seal
[Date/Time with time zone]	[Name — Signature — Role — ID]	[Date/Time]	[Name — Signature — Role — Agency/Facility — ID]	[Item #s or entire sealed container ID]	[Purpose]	[From location ID] → [To location ID]	[Intact / Broken / N/A]	[Dry / Wet / Damaged / Leakage]	[Temperature condition or N/A]	[Courier/Agency or N/A]	[Tracking # or N/A]	[Seal # or N/A]

Handling and Processing Events

(Use when evidence is opened for verification, repackaged, sampled/aliquoted, photographed, tested, or temporarily transferred to an analyst workspace.)

Event Date/Time	Handler Name/ID	Items Involved (by Item #)	Action Performed	Reason/Purpose	Seal Status Before	Seal Status After	New Seal Number(s)	Notes
[Date/Time]	[Name/ID]	[Item #s]	[Opened / Verified / Repackaged / Aliquoted / Photographed / Tested / Resealed / Other]	[Reason]	[Status before]	[Status after]	[New seal #s]	[Notes]

Derived Specimen Linkage

(Track aliquots and extracts. Derived specimens require their own chain-of-custody tracking to the same standard as original evidence.)

Parent Item #	Derived Item ID(s)	Quantity Removed	Quantity Remaining	New Container Identifier(s)	Chain-of-Custody Link Established
[Parent Item #]	[Derived ID(s)]	[Quantity/units]	[Quantity/units]	[Container ID(s)]	[Yes / No]

Secure Storage Record

(Use when evidence is held prior to external transfer.)

Item # / Container ID	Storage Location Identifier	Access Limitation	Temperature Requirement	Requirement Met at Placement	Special Notes
[Item # or Container ID]	[Locker/Refrigerator/Freezer/Shelf/Bin ID]	[Locked / Restricted access]	[Room temp / Refrigerated / Frozen / Other]	[Yes / No]	[Notes, e.g., wet items requiring drying, liquid specimens]

Discrepancy and Incident Log

(Document integrity threats: broken/missing seals, label mismatches, undocumented transfers, leaks, unauthorized handling, temperature excursions, etc. If no discrepancies occurred, state: "No discrepancies identified.")

Incident ID	Date/Time Discovered	Discovered By (Name/ID)	Items Affected (Item #s)	Objective Description	Immediate Containment Steps	Notifications (Name/Role/Agency & Date/Time)	Resolution Status & Date/Time
[Incident ID]	[Date/Time]	[Name/ID]	[Item #s]	[Objective description only; no inference]	[Actions taken immediately]	[Who was notified and when]	[Open / Resolved] — [Date/Time] — [Resolution summary]

Final Disposition

(Document endpoint when evidence leaves custody or is destroyed/retained.)

Date/Time	Disposition Type	Authorization Basis	Recipient Identity & Verification Method	Witness (if required)	Items Disposed (Item #s)	Method/Location (for destruction)	Notes
[Date/Time]	[Released to law enforcement / Released to crime lab / Returned to lawful owner / Destroyed / Retained]	[Policy / Court order / ME authorization / Other]	[Recipient name/role/agency & badge/employee ID or government ID]	[Witness name/role/ID or N/A]	[Item #s]	[Destruction method & location or N/A]	[Notes]

Attestation

I attest that the entries on this log are accurate to the best of my knowledge and were made in accordance with applicable policies and procedures.

Preparer: [Printed name] — [Role/ID] — [Signature] — [Date/Time]

Supervisor/Reviewer: [Printed name] — [Role/ID] — [Signature] — [Date/Time] (Recommended for high-stakes cases or when discrepancies exist)

Corrections and Late Entries

• Paper records: Use single-line strike-through; add initials and date/time; do not obscure original entries.
• Electronic records: Amendments must be time-stamped with author identity and reason; preserve original entry visibility.
• Late entries: Clearly label as "Late Entry" and distinguish event date/time from documentation date/time; include rationale.