Request forms

This section provides request forms for health professionals regarding the collection, preparation and use of selected blood components.

Request forms
Notification of a Special Blood Component Requirement (111F047) (pdf, 84 KB)
Request for Blood Bank Tests and Blood Components or Products (111F018) (pdf, 199 KB)
This form is used to request pretransfusion compatibility testing and supply of blood components or products for transfusion.

The reverse side of the form provides brief guidelines on the indications for transfusing blood components and a list of the main blood components and products available in New Zealand.
Approval for Intravenous Immunoglobulin (Intragam P) (111F075) (pdf, 53 KB)

You may need to download Adobe Reader to view the PDF files. It is available free from the Adobe site (external link) .

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