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Blood Bank Annual Statistics - Umbilical Cord Blood Facilities - Department of Health (New Jersey) Mobile App

Umbilical Cord Blood Facilities in New Jersey can now file their annual Blood Bank Statistics simply by filling out this app straight from any mobile device. Comes with full capture fields for all the necessary information including the number processed, collected, stored, and more.

  • Lendlease
  • The Cooperative
  • PG&E
  • Red Bull
  • Mirvac

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Take a peek inside the Blood Bank Annual Statistics - Umbilical Cord Blood Facilities - Department of Health (New Jersey) Mobile App

Included Features

Our App Builder gives you the power to easily add and remove the ones you want. {{controller.show_all ? 'See included features.' : 'See more features.'}}

  • {{data.title}}

Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico textbox

    Name of Facility

  • Ico integer

    CALENDAR YEAR

  • Ico textbox

    Address

  • Ico textbox

    Name of Individual Completing Form

  • Ico textbox

    Telephone Number

  • Ico integer

    1. Number of Intraoperative Autologous Blood collections performed in New Jersey

  • Ico integer

    2. Number of Postoperative Autologous Blood collections performed in New Jersey

  • Ico integer

    3. Number of Acute Normovolemic Hemodilution procedures performed in New Jersey

  • Ico integer

    4. Number of Platelet Rich Plasma Gel procedures performed in New Jersey

  • Ico statictext

    Attach a list of facilities in New Jersey where the above procedures were performed.

  • Ico textbox

    Name of Medical Director (Print)

  • Ico date

    Date

  • Ico signature

    Signature of Medical Director

  • ...and More!

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More Information


  • Creator: Team GoCanvas
  • Language: English
  • Country: United States of America
  • Type: Data Collections
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