The heel is cleaned with alcohol or sterile water and dried with sterile cotton wool.
The skin is punctured using a sterile disposable lancet (2.4 mm max. length) around the outer or inner border of the heel while holding the skin taut. It is helpful to make two quick punctures close together. Warming the foot before puncturing also helps blood flow.
The puncture is allowed to ooze for a moment. The first drop of blood is wiped away and then a very gentle intermittent pressure is applied to the area around the puncture site.
Blood is dropped onto the card, or the card gently touched to the blood, allowing a single large drop to completely fill each circle. A circle should not be filled by successively layering drops of blood.