Therapeutic phlebotomy is the removal of blood to treat conditions such as an excess production of red blood cells (polycythemia) or excess levels of iron (hemochromatosis). Therapeutic phlebotomy MUST be prescribed by a licensed healthcare provider (physician, physician assistant, or nurse practitioner). The prescription must include patient information (name, DOB or SSN, and telephone number), diagnosis, frequency of phlebotomy, and minimum acceptable hematocrit level.Ĭlick here to download the Provider’s Request for Therapeutic Phlebotomy form. Positive results are reported in writing to you, your doctor, the medical director of the hospital transfusion service and others as required by law.Īll collections gathered via autologous donations are for your specific use only and are not released to the community if it is not transfused by you. Testing is done on the blood that is collected for infectious disease, such as HIV and hepatitis. All autologous donations must be complete at least three business days prior to your surgery. These appointments are usually scheduled one week apart. Autologous Request FormĬlick here to download information. All paperwork must be complete in order to proceed.Ĭlick here to download the form. Once received Blood Bank of Alaska will contact you to schedule a donation. A written request must be completed prior to your surgery by your doctor and submitted to Blood Bank of Alaska. It is up to your physician to determine if this donation is necessary. Autologous Blood Service – Therapeutic Blood ServiceĪutologous procedure allows you to donate blood to yourself prior to an upcoming operation, with physician approval.
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