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Click ‘Get Form’ to open the kabafusion document in the editor.
Begin by filling in the 'KabaFusion Staff Initials' and 'Date' fields at the top of the form. This ensures proper authorization is recorded.
In the 'Patient Referral and Prescription for Blood Transfusion' section, enter the patient's name, date of birth (DOB), diagnosis/ICD-10 code, height, weight, and any known allergies.
Specify blood/blood products needed by checking appropriate boxes and documenting reasons for transfusions as required. Fill in units and rates for Packed Blood Cells and Platelets.
Complete any additional orders such as medications or dietary instructions as necessary.
Ensure to sign and date at the bottom of the form where indicated, including your NPI number.
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