As our hospital customer, we invite you to use the tools provided in this section.
Most commonly used forms, product codes and other links are located here for your convenience and may be downloaded or accessed as needed.
Immunohematology Reference Laboratory Forms |
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Consultation Request Form |
Antigen Negative RBC/HLA Request |
Compatibility Testing Requisition |
30-Day Specimen – Pre-Op Type & Screen |
Adverse Transfusion Reaction Form |
The products and codes listed below are those we most commonly manufacture.
These codes are applicable to 500ml collections.
Leukoreduced RBCs |
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E0336 – RED BLOOD CELLS|CPD>AS1/500ML/REFG|RESLEU:<5E6 |
E0678 – APHERESIS RED BLOOD CELLS|CP2D>AS3/XX/REFG|RESLEU:<5E6 |
E0685 – APHERESIS RED BLOOD CELLS|CP2D>AS3/XX/REFG|RESLEU:<5E6|1ST CONTAINER |
E0686 – APHERESIS RED BLOOD CELLS|CP2D>AS3/XX/REFG|RESLEU:<5E6|2ND CONTAINER |
E4543 – APHERESIS RED BLOOD CELLS|ACD-A>AS3/XX/REFG|RESLEU:<5E6 |
E4544 – APHERESIS RED BLOOD CELLS|ACD-A>AS3/XX/REFG|RESLEU:<5E6|1ST CONTAINER |
E4545 – APHERESIS RED BLOOD CELLS|ACD-A>AS3/XX/REFG|RESLEU:<5E6|2ND CONTAINER |
Plasma |
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E7644 – APHERESIS PLASMA|ACD-A/XX/<=-18C|RT<=24H FROZEN<=24H |
E7924 – APHERESIS PLASMA|CP2D/XX/<=-18C|FROZEN <=24H |
E7925 – APHERESIS PLASMA|CP2D/XX/<=-18C|FROZEN <=24H|1ST CONTAINER |
E7926 – APHERESIS PLASMA|CP2D/XX/<=-18C|FROZEN <=24H|2ND CONTAINER |
E2555 – PLASMA|CPD/XX/<=-18C|FROZEN <=24H |
E4142 – APHERESIS FRESH FROZEN PLASMA|CP2D/XX/<=-18C |
E6460 – APHERESIS FRESH FROZEN PLASMA|CP2D/XX/<=-18C|1ST CONTAINER |
E6461 – APHERESIS FRESH FROZEN PLASMA|CP2D/XX/<=-18C|2ND CONTAINER |
Convalescent Plasma |
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E9747 – APHERESIS CONVALESCENT PLASMA|ACD-A/XX/<=-18C|COVID-19 |
Apheresis Platelets |
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E3077 – APHERESIS PLATELETS|ACD-A/XX/20-24C|RESLEU:<5E6 |
E3087 – APHERESIS PLATELETS|ACD-A/XX/20-24C|RESLEU:<5E6|1ST CONTAINER |
E3088 – APHERESIS PLATELETS|ACD-A/XX/20-24C|RESLEU:<5E6|2ND CONTAINER |
E3089 – APHERESIS PLATELETS|ACD-A/XX/20-24C|RESLEU:<5E6|3RD CONTAINER |
E5030 – APHERESIS PLATELETS|ACD-A/XX/20-24C|ResLeu:<5E6|Bacterial monitoring |
E5031 – APHERESIS PLATELETS|ACD-A/XX/20-24C|ResLeu:<5E6|1st container|Bacterial monitoring |
E5032 – APHERESIS PLATELETS|ACD-A/XX/20-24C|ResLeu:<5E6|2nd container|Bacterial monitoring |
E5033 – APHERESIS PLATELETS|ACD-A/XX/20-24C|ResLeu:<5E6|3rd container|Bacterial monitoring |
E5034 – APHERESIS PLATELETS|ACD-A/XX/20-24C|Irradiated|ResLeu:<5E6|Bacterial monitoring |
E5035 – APHERESIS PLATELETS|ACD-A/XX/20-24C|Irradiated|ResLeu:<5E6|1st container|Bacterial monitoring |
E5036 – APHERESIS PLATELETS|ACD-A/XX/20-24C|Irradiated|ResLeu:<5E6|2nd container|Bacterial monitoring |
E5037 – APHERESIS PLATELETS|ACD-A/XX/20-24C|Irradiated|ResLeu:<5E6|3rd container|Bacterial monitoring |
E5073 – APHERESIS PLATELETS|ACD-A/XX/20-24C|Irradiated|ResLeu:<5E6|<3E11 plts|Bacterial monitoring
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Acrodose Pooled Platelets |
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E5804 – POOLED PLATELETS|CPD/XX/20-24C|RESLEU:<5E6|5 UNITS|BACTERIAL TEST |
Cold Stored Platelets |
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E9467 – APHERESIS PLATELETS|ACD-A/XX/REFG||RESLEU:<5E6 |
E9468 – APHERESIS PLATELETS|ACD-A/XX/REFG||RESLEU:<5E6|1st Container |
E9469 – APHERESIS PLATELETS|ACD-A/XX/REFG||RESLEU:<5E6|2nd Container |
E9470 – APHERESIS PLATELETS|ACD-A/XX/REFG||RESLEU:<5E6|3rd Container |
Cryo Singles |
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E5165 – CRYOPRECIPITATE|NONE/XX/<=-18C |
Cryo Pools |
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E5621 – POOLED CRYOPRECIPITATE|NONE/XX/<=-18C|5 UNITS |
Whole Blood |
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E0023 – WHOLE BLOOD|CPD/500ML/REFG |