Guest guest Posted February 20, 2006 Report Share Posted February 20, 2006 Deer Park, Tx. 77536 281/476-4600 281/930-8494 FAX Platinum Analytical Urine Sample Collection Protocol A urine sample of the first morning urination should be placed in a sterile collection vial. Sterile collection vials may be purchased at any medical supply house. A chain of custody form should be completed by the patient. This form may be downloaded from the Internet at www.expertox.com. Put an X by Heavy Metals and write in Platinum. The urine sample vial, along with a similar empty vial (for blank correction), and the completed chain of custody form should be shipped in a small cardboard box containing blue ice for temperature control during overnight shipment. Please exercise caution in ensuring that the specimen vial is securely sealed (can be placed inside a zip lock bag), in order that accidental leaks do not occur during shipping and void the testing. Complete the questionnaire to be included in the research project. Place the questionnaire and a $150.00 cashier's check in the shipping box. The results of your testing will be mailed to you at the address you have included in the chain of custody form unless you indicate other instructions. For any further assistance with this collection protocol, do not hesitate to call ExperTox at 281/476-4600. QUESTIONNAIRE PLATINUM TESTING Have you ever been treated with platinum-based chemotherapy drugs, for example cisplatin, carboplatin, and/or iproplatin? _____yes _____no If yes, how long was your treatment? __________ How long since last exposure?____________ Have you ever worked in an industry that used chloroplatinic, or hexachloroplatinic acid? _____yes _____no If yes, how long was your exposure? ___________ How long since last exposure?____________ Have you ever made platinum jewelry? _____yes _____no If yes, how many months or years did you make platinum jewelry?_____________ How long since last exposure? _____________ Have you ever been in an occupation where you were exposed to heavy amounts of car exhausts? For instance roadside worker? _____yes _____no Other____________________________ _____yes _____no If yes, how long did you work in this occupation? _______________ How long has it been since you worked in this occupation? ________________ Have you or members of your household worked in any capacity in a muffler shop or other automotive type of business? ________yes ________no If yes, how many years were you or they employed in this occupation where you might have inhaled dust either directly or from handling of their clothing?___________ How long has it been since you or they worked in this occupation?_____________ Do you know if you have any dental amalgams that include platinum? ____yes_____no Don't know_________If yes, how many teeth contain platinum amalgams and how long have they been in your mouth?_____________________ What implanted devices have you had in your body. Please list year implanted with manufacturer, type of implant (if breast implants please list type such as saline, silicone gel, double lumen, and if textured), any identifying markers (serial, lot number, etc.), year removed if no longer in your body, and status of implant when removed (for instance ruptured, intact but with heavy " leaking " of gel indicated, etc.) If you need additional space, please use back of paper. 1.Year implanted______ Type of implant______________________________________ Manufacturer of Implant (if known) ___________________________________________ Identifying Markers_______________________________________________________ Still Implanted with this device? Yes_______ No______ If no, year explanted_________ Status of Implant when removed_____________________________________________ 2.Year implanted_____ Type of implant_______________________________________ Manufacturer of Implant (if known) ___________________________________________ Identifying Markers_______________________________________________________ Still implanted with this device? Yes_______No_______If no, year explanted_________ Status of implant when removed______________________________________________ List the year you were explanted (if explanted) with no implant reinserted__________ Was your implant removed " en bloc " (implant and scar capsule removed as a unit)? Yes_____No.______ Was your scar capsule left inside your body? Yes_____No____ Have you done any detoxing to remove heavy metals from your body? Yes____No___ If yes, please indicate method and period of time used.___________________________ Have you had any children born after implantation? Yes_____No______ If yes, how many years were you implanted before your children were born?__________ Please list number of years implanted for each child being tested. I hereby give my voluntary consent for platinum testing of my urine sample and release of the test results by ExperTox Inc. to S.V.M Maharaj and Chemically Associated Neurological Disorders (CANDO) to be included in CANDO Research Project #2. I understand that my name will not be identified in any published research as a result of this testing. I further agree to hold ExperTox Inc.; its agents, directors, officers or employees as well as S.V.M. Maharaj, Ph.D. or CANDO harmless from any and all liability or negative effect on any pending litigation regarding the manufacturer of implanted devices. Name__________________________ Social Security #_________________ Address________________________ _______________________________ Phone Number___________________ e-mail address____________________ Please send one copy of this questionnaire to ExperTox with your sample to be tested. Send a duplicate copy to Chemically Associated Neurological Disorders (CANDO) P.O. Box 682633, Houston, Tx. 77268-2633. If you have questions call 281/444-0662 To read letter explanatory letter from Keeling of CANDO, click here: FastCounter by bCentral.. --------------------------------------------------------------------- ----------- HOME SUPPORT GREATLINKS QUACK LIBEL VICTORY DEFAMATION CASE PUBLIÇATIONS DAILY NEWS Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 20, 2006 Report Share Posted February 20, 2006 Thanks so much for posting this! . . . Very good information! Please EVERYONE make a copy of this and keep it to give to anyone who may need it. Hugs, Rogene --- loverofmysoul60 <loverofmysoul60@...> wrote: > Deer Park, Tx. 77536 > > 281/476-4600 > > 281/930-8494 FAX > > > > Platinum Analytical Urine Sample Collection Protocol > > > > A urine sample of the first morning urination should > be placed in a > sterile collection vial. Sterile collection vials > may be purchased > at any medical supply house. > A chain of custody form should be completed by the > patient. This > form may be downloaded from the Internet at > www.expertox.com. Put > an X by Heavy Metals and write in Platinum. > The urine sample vial, along with a similar empty > vial (for blank > correction), and the completed chain of custody form > should be > shipped in a small cardboard box containing blue ice > for temperature > control during overnight shipment. > Please exercise caution in ensuring that the > specimen vial is > securely sealed (can be placed inside a zip lock > bag), in order that > accidental leaks do not occur during shipping and > void the > testing. > Complete the questionnaire to be included in the > research project. > Place the questionnaire and a $150.00 cashier's > check in the > shipping box. > The results of your testing will be mailed to you at > the address you > have included in the chain of custody form unless > you indicate other > instructions. > For any further assistance with this collection > protocol, do not > hesitate to call ExperTox at 281/476-4600. > > > QUESTIONNAIRE > > PLATINUM TESTING > > > > Have you ever been treated with platinum-based > chemotherapy drugs, > for example cisplatin, carboplatin, and/or > iproplatin? _____yes > _____no If yes, how long was your treatment? > __________ How > long since last exposure?____________ > > > > Have you ever worked in an industry that used > chloroplatinic, or > hexachloroplatinic acid? > > _____yes _____no If yes, how long was your > exposure? > ___________ How long since last > exposure?____________ > > > > Have you ever made platinum jewelry? _____yes > _____no If yes, > how many months or years did you make platinum > jewelry?_____________ > How long since last exposure? > > _____________ > > > > Have you ever been in an occupation where you were > exposed to heavy > amounts of car > exhausts? For > instance roadside > worker? > _____yes _____no > > Other____________________________ > > _____yes _____no > > If yes, how long did you work in this occupation? > _______________ > How long has it been since you worked in this > occupation? > ________________ > > > > Have you or members of your household worked in any > capacity in a > muffler shop or other automotive type of business? > ________yes > ________no If yes, how many years were you or > they employed in > this occupation where you might have inhaled dust > either directly or > from handling of their clothing?___________ How long > has it been > since you or they worked in this > occupation?_____________ > > > > Do you know if you have any dental amalgams that > include platinum? > ____yes_____no > > Don't know_________If yes, how many teeth contain > platinum amalgams > and how long have they been in your > mouth?_____________________ > > > > What implanted devices have you had in your body. > Please list year > implanted with manufacturer, type of implant (if > breast implants > please list type such as saline, silicone gel, > double lumen, and if > textured), any identifying markers (serial, lot > number, etc.), year > removed if no longer in your body, and status of > implant when > removed (for instance ruptured, intact but with > heavy " leaking " of > gel indicated, etc.) > > If you need additional space, please use back of > paper. > > 1.Year implanted______ Type of > implant______________________________________ > > Manufacturer of Implant (if known) > ___________________________________________ > > Identifying > Markers_______________________________________________________ > > Still Implanted with this device? Yes_______ > No______ If no, year > explanted_________ > > Status of Implant when > removed_____________________________________________ > > > > 2.Year implanted_____ Type of > implant_______________________________________ > > Manufacturer of Implant (if known) > ___________________________________________ > > Identifying > Markers_______________________________________________________ > > Still implanted with this device? > Yes_______No_______If no, year > explanted_________ > > Status of implant when > removed______________________________________________ > > > > > > > > List the year you were explanted (if explanted) with > no implant > reinserted__________ > > > > Was your implant removed " en bloc " (implant and scar > capsule removed > as a unit)? > > === message truncated === Quote Link to comment Share on other sites More sharing options...
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