blood component requisition form
LAW ENFORCEMENT PHLEBOTOMY TOOLKIT:
The following information shall be included on the form for each blood draw. a. Date, time, and physical location where blood draw was performed b. Blood
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Blood or Blood Component Transfusion
Volume Requested (If applicable) Use only when different from standard amount, i.e., exchange transfusion 50 ml. at on . STANDARD FORM 518 BACK (REV. 9-92)
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Blood and Blood Component Request Form
Blood must be delivered PROMPTLY to appropriate unit upon pick up/receipt in tube station. Use this form when IHIS requisition is unavailable. Instructions for
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