Autologous Donations: Ordering and Scheduling Information
A Special Collections Order form from the patient’s physician is required to schedule collection appointments.
Follow the steps below for completing the Special Collection Order form.
1. Sections A, B, C, and D are to be completed by the ordering physician.
2. Section E is to be completed if cardiac/cardiovascular disease is known.
3. Indicate special instructions on form and/or directly notify Red Cross staff.
4. Indicate special instructions the hospital may require. (Hospital requirements may be specific to an individual institution and vary by location.)
Fax the completed Special Collections Order form to the fax number listed below.
Upon receipt of the faxed order, the Special Collections Scheduling staff will review the order to make sure all information is legible and complete. If at this time there is a question, more information is needed, or there is a problem with the order, the physician’s office will be contacted before proceeding with the scheduling process.
Red Cross staff will contact the patient and review his/her medical history to determine donor eligibility.
If the patient is eligible to donate, the donation(s) is scheduled.
If the donation criteria are not met, the Red Cross Medical Director will be notified.
Using American Red Cross Blood Service Directives and federal guidelines, the Medical Director will make the determination whether to collect the autologous unit.
Following are timing requirements:
Appointments must be made at least 3 days prior to the collection date to allow for preparation and transport of the required forms and labels to the collection site.
Allow at least 10 working days from collection date to the surgery date for the order to be processed and blood to be collected, tested, and delivered to the hospital.
Donations cannot occur more frequently than once every 72 hours.
If the Red Cross is unable to collect the autologous blood units ordered for any reason, the ordering physician and transfusion service will be notified.
Contact: Special Collections Scheduling Email: [email protected] Number: (800) 634-9069
Fax Number: 800-886-7024
Directed Donations: Ordering and Scheduling Information
A Special Collections Order form from the patient’s physician is required to schedule collection appointments.
Responsibility of the patient or patient representative and ordering physician:
Recruitment of ABO/Rh compatible donor(s).
Documentation of blood type must be sent at time of Special Collection Order submission. Note: Directed donations from a potential father to the potential mother to his children in childbearing years is not allowed due to a serious risk of fetal blood group incompatibility that may affect future pregnancies.
Follow the steps below for completing the Special Collection Order form.
1. Sections A, B, C and D are to be completed by the ordering physician.
2. Indication of familial relationship between blood donor(s) to recipient must be reported by the ordering physician.
3. Indicate special instructions on form and/or directly notify Red Cross Special Collections staff including: CMV negative and Irradiation (specific to related blood donors).
4. Indicate special instructions the hospital may require. (Hospital requirements may be specific to an individual institution and vary by location.)
Fax the completed Special Collections Order form to the fax number listed below.
Upon receipt of the faxed order, the Special Collections Scheduling staff will review the order to make sure all information is legible and complete. If at this time there is a question, more information is needed, or there is a problem with the order, the physician’s office will be contacted before proceeding with the scheduling process.
The Red Cross staff will contact the donor and review his/her medical history to determine donor eligibility. If the donor is eligible to donate, the donation is scheduled.
Following are timing requirements:
Appointments must be made at least 3 days prior to the collection date to allow for preparation and transport of the required forms and labels to the collection site.
Allow at least 10 working days from collection date to the surgery date for the order to be processed and blood to be collected, tested, and delivered to the hospital.
If the Red Cross is unable to collect the blood units ordered for any reason, the ordering physician and transfusion service will be notified.
Contact: Special Collections Scheduling Email: [email protected] Phone Number: (800) 634-9069
Fax Number: 800-886-7024