The present invention is a specimen capture and collection form that utilizes a self laminating form assembly having first and second separable parts one of which is used in the collection, capture and retention of a sample of material to be analyzed and the other of which is used for recording the particular transaction for which the sample of specimen was collected. The form assembly is also provided with a unique element which enables the separation of excess sample collection material to be easily and conveniently separated from the remainder of the form assembly so as to not contaminate the specimen as well as prevent the inadvertent removal of the specimen from the form assembly. The construction is also provided with distinct verification areas to confirm authenticity of the form construction.