Request for Blood Bank Tests and Blood Components or Products

Form Template

The Request for Blood Bank Tests and Blood Components or Products mobile app allows you to replace your paper blood bank request with a smartphone, tablet or desktop.

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The mobile form includes fields to document items such as patient details, indication for transfusion and relevant medical history, blood bank tests and component/product requests, specimen collector declaration and transfusion details. Once the mobile app is filled out a secure PDF is generated. The PDF is easy to share, and a copy is stored in your account for your blood bank records. You can also use the App Builder to personalize and customize this mobile form. Relevant history determines specimen validity period. Standard validity for Group and Screen specimens is 7 days. During, and for 3 months after pregnancy or transfusion, validity is 72 hours. f no relevant history is given, validity will be 72 hours. Sample validity may be extended up to 21 days for pre-planned surgery; record date in the app. Certify that the blood specimen(s) accompanying this request was drawn from the patient named in the app.

Features
  • Signature Capture
  • Submission Editing
  • Reference Data
  • Dispatch
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Platforms
  • iPhone
  • iPad
  • Android
  • Windows
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Integrations
  • Quickbooks
  • Salesforce
  • Google Docs
  • Dropbox
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*The Capterra SoftwareAdvice ​and GetApp logos are a service mark of Gartner, Inc. and/or its affiliates and is used herein with permission.*

Don't take our word for it...

“I’m not a tech guy and I was able to pick this thing up in probably an hour, and actually start to build apps. I’ve done them over lunch when I’ve gotten frustrated with a process that didn’t exist in our company. So for non tech people who’ve got a problem, the support here is awesome and I’d recommend it to anybody, not just in our industry.”

Dave Kramer, PennLine Service

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