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SPECIAL REQUEST ORDER FORM (RBC) All Orders must be faxed Section 1 to be filled out by Hospital /Section 2 to be filled out by CBS. Site: Edmonton Fax Number: (780) 4334478 Phone Number: (780) 4310777

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How to fill out blood component order form

How to fill out a blood component order form:

01

Start by carefully reading the instructions on the form and familiarizing yourself with the required information.

02

Begin by providing your personal details, including your name, contact information, and the name of your healthcare organization.

03

Indicate the date and time of the order, as well as any specific urgency or special instructions.

04

Specify the type of blood component(s) you need by selecting the appropriate options from the provided checkboxes or drop-down menus.

05

Provide details about the patient in need of the blood component(s), including their name, date of birth, and any relevant medical ID or identification number.

06

Enter the required information about the healthcare facility where the blood component(s) will be used, such as the name, address, and contact information.

07

If applicable, indicate any additional requirements or special preferences, such as specific blood group compatibility or particular testing needs.

08

Double-check all the information you have provided to ensure accuracy and completeness.

09

Sign and date the form to certify that the information provided is true and correct.

10

Submit the completed form to the appropriate authority or department responsible for blood component orders.

Who needs a blood component order form:

01

Healthcare professionals: Doctors, surgeons, or other medical professionals who require blood components to be used for medical procedures or transfusions.

02

Hospitals and healthcare facilities: Institutions that provide medical care and require a steady supply of blood components for their patients.

03

Blood banks and blood donation centers: Organizations responsible for collecting, processing, and distributing blood components according to the orders received from healthcare professionals and facilities.

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