Get Blood Bank Request Form

Completing the Blood Bank Request Form online is a critical step in ensuring accurate testing and proper patient care. This guide provides a comprehensive overview of how to successfully navigate each section of the form, making the process straightforward and efficient for all users.

Follow the steps to complete the Blood Bank Request Form online.

1. Click ‘Get Form’ button to access the Blood Bank Request Form and open it for editing.
2. Carefully prepare the appropriate sample and ensure it is labeled correctly with the date of collection and patient information. Both identifiers must match the patient information provided on the reverse side of the form to avoid testing rejection.
3. Indicate the type of sample by selecting from the following options: ABO/Rh, DAT, Antibody Titer, or Antibody ID, and ensure that at least the correct number of EDTA and clot tubes are prepared.
4. Enter the submitting facility information, including the facility name, phone number, fax number, and the requesting physician's name in the designated sections.
5. Fill out the patient information fields accurately, including the patient’s name, ID or LIS#, date of birth, specimen date, and diagnosis.
6. In the patient history section, ask the patient the prescribed questions and document the answers regarding antibody inquiries, medications, and transfusion history, as incomplete history may delay processing.
7. Specify the test requests by checking the applicable boxes for ABO/Rh, DAT, Antibody Titer, Antibody ID, and any blood products needed (PRBC’s, PLTS, FP, CRYO), indicating the quantity and urgency required.
8. Include any relevant laboratory data, such as the ABO/Rh, antibody screen results, and crossmatch results in the designated fields.
9. Review the completed form for accuracy and completeness before submitting it. Users can save changes, download, print, or share the form as needed.

Complete the Blood Bank Request Form online to ensure efficient processing and accurate testing.