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  • Therapeutic Phlebotomy Consent Form

Get Therapeutic Phlebotomy Consent Form

Therapeutic Phlebotomy Department 1021 112th Ave NE Bellevue, WA 98004 (800) 2664033 or (425) 4535098 Fax (425) 4624316 Email: therapeuticphlebotomy psbc.org Informed Consent for Therapeutic Phlebotomy.

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How to fill out the Therapeutic Phlebotomy Consent Form online

Filling out the Therapeutic Phlebotomy Consent Form online can be a straightforward process if you follow the correct steps. This guide is designed to provide you with a clear and supportive approach to completing the form effectively.

Follow the steps to fill out your consent form correctly

  1. Press the ‘Get Form’ button to access the Therapeutic Phlebotomy Consent Form and open it in your preferred online editor.
  2. Read through the informed consent section carefully. This section outlines the procedure, the possible benefits, and the associated risks of therapeutic phlebotomy. Ensure you understand all information before proceeding.
  3. Locate the Patient’s Statement section. If you are over 18 years old, check the relevant box confirming that you are the patient and at least 18 years of age.
  4. Sign your name in the designated area under Patient’s Signature, and fill in today’s date.
  5. Print your name clearly in the section labeled Patient’s Printed Name, ensuring it matches your identification documents.
  6. If the patient is under 18 years of age, check the appropriate box and complete the additional fields with the name of the patient, the printed name and signature of the parent or guardian, today's date, and the relationship to the patient.
  7. Review the entire form for accuracy and completeness. Make sure all necessary fields are filled out correctly before submitting.
  8. Once satisfied, save your changes in the online editor. You can also choose to download, print, or share the completed form as needed.

Take the next step in your therapeutic care by completing the consent form online.

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Patient consent is documented on the “Therapeutic Whole Blood Phlebotomy Consent” form. Once consent has been obtained, the phlebotomist evaluates the patient based on criteria set forth by the Medical Director.

During a phlebotomy, approximately one pint of blood will be taken from a vein in your arm. The actual process takes approximately 30-45 minutes. After the procedure is completed, it will be necessary for you to rest for 15-20 minutes and drink some juice or water. The entire procedure takes about one hour.

Therapeutic phlebotomy is performed in a medically supervised environment. It is commonly performed in a blood donor center, apheresis unit, physician office, or at home by a well‐trained phlebotomist, but home phlebotomy is rarely performed.

Instructions After Your Procedure Drink more liquids than usual for 1 to 2 days after your procedure. ... Avoid alcohol and drinks with caffeine (such as coffee, tea, and cola) for the rest of the day after your procedure. Avoid strenuous exercise (such as jogging) for 1 day after your procedure.

One common procedure nurses perform is therapeutic phlebotomy, where about 500 ml of blood is removed through a large-bore needle over 15-30 minutes. The procedure is ordered as a treatment for hereditary hemochromatosis, polycythemia vera, and secondary polycythemia.

Treatment Overview Health professionals perform phlebotomy in a medical clinic. The process is similar to donating blood. A health professional inserts a needle into a vein in your arm and removes about 500 mL (17 fl oz) of blood.

Phlebotomy is when blood is drawn from the body. Therapeutic phlebotomy is when blood is drawn to treat a disease. It's also called bloodletting.

Therapeutic phlebotomy is currently indicated for the treatment of hemochromatosis, polycythemia vera, porphyria cutanea tarda, sickle cell disease, and nonalcoholic fatty liver disease with hyperferritinemia.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232