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Get the free Living Donor Infectious Disease Screening Requisition form. Screening Requisition

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Scanning Label or Accession # (lab only)Living Donor Infectious Disease Screening RequisitionPatientPHNExpiry: Legal Last Nameless First NameMiddle NamePreferred NameAddressProvider(s)Date of Birth
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01
Step 1: Gather all the necessary medical information and forms required for the living donor infectious disease evaluation.
02
Step 2: Schedule an appointment with the designated medical facility or clinic.
03
Step 3: Bring the completed forms and medical information to the appointment.
04
Step 4: Undergo a comprehensive medical evaluation, including blood tests, physical examination, and screening for infectious diseases.
05
Step 5: Follow any additional instructions provided by the medical professionals during the evaluation process.
06
Step 6: Await the results of the infectious disease screening.
07
Step 7: If cleared of infectious diseases, proceed with the living donor process, following the guidance of the medical team.
08
Step 8: If any infectious diseases are detected, consult with the medical team to discuss appropriate treatment options or potential disqualification from being a living donor.

Who needs living donor infectious disease?

01
Living donor infectious disease evaluation is required for individuals who want to donate organs or tissues to someone in need of a transplant.
02
This evaluation ensures that the potential donor does not have any infectious diseases that could be transmitted to the recipient during the transplantation process.
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Living donor infectious disease refers to any infectious disease or condition that a living donor may have and could potentially be transmitted to the recipient through the donated organ or tissue.
Healthcare professionals and transplant centers are required to file living donor infectious disease information.
Living donor infectious disease information can be filled out using a specific form provided by the healthcare professional or transplant center.
The purpose of living donor infectious disease reporting is to ensure that recipients are aware of any potential risks associated with the donated organ or tissue.
Information such as the type of infectious disease, the severity, treatment history, and any potential risks to the recipient must be reported.
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