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Cellular Therapy Product Collection Information Form Special Patient Services Department Type of Collection: Autologous Directed NOTE: To submit form, please print completed form “as a PDF and either
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Cellular formrapy product collection is a collection of products derived from cell therapy that are used in the treatment of various medical conditions.
Manufacturers and distributors of cellular formrapy products are required to file the collection.
The form for cellular formrapy product collection can be filled out online or submitted by mail.
The purpose of the collection is to track the distribution and use of cellular formrapy products for regulatory purposes.
Information such as the name of the product, manufacturer, distributor, lot number, quantity distributed, and recipient information must be reported.
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