Blood request form 2025

1. Click ‘Get Form’ to open the Blood and Blood Component Request Form in the editor.
2. Begin by entering the patient's full legal name. If available, use a patient label for accuracy.
3. Input the medical record number to ensure proper identification of the patient.
4. Verify patient identification, consent, vitals, and transfusion orders before proceeding.
5. In the 'Product' section, specify the quantity of each blood component required: RBC, Plasma, PLT, CRYO, and RhIg.
6. Enter your employee badge number in the designated field; this is mandatory for processing your request.
7. Record your tube station number where the blood components will be sent.
8. Fill in the current date and time of the request.
9. Provide your RN phone number for any follow-up questions regarding your request.
10. Once completed, send the form to Transfusion Service tube station 231 or bring it to the Blood Bank window if picking up directly.

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