Australian Red Cross Blood Service

Completing a request form accurately and legibly is important in transfusion practice

Completing the blood request form accurately and legibly is important to ensure that the right quantity and type of blood product is provided to the right patient at the right time in the right place.

Ensure blood products are given only when clearly indicated.

Recommended procedure

• Hospitals must have a written policy for blood transfusion requests, which includes who can prescribe blood.

• The request form should contain the following information

  • Full patient name

  • Unique patient identification number and/or date of birth

  • Location of the patient

  • Number and type of blood components and blood products requested

  • Date and time required, including degree of urgency

  • Relevant past obstetric and transfusion history

  • Patient’s diagnosis

  • Indication for transfusion

  • Identity and signature of the sample collector and witness

• Hospitals must have a policy for the requesting of special blood requirements (such as CMV seronegative, leucodepleted, irradiated, etc)