Request forms

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

Request forms
Approval for Immunoglobulin Products (pdf, 215 KB)
Notification of a Special Blood Component Requirement (111F047) (pdf, 247 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.
Request for Collection, Preparation and Dispensing of Serum Eye Drops (pdf, 135 KB)
Request for Investigation by Reference Laboratory (pdf, 34 KB)
Request for Tissue Typing, Diagnostic Testing (pdf, 46 KB)
Request for Tissue Typing, Monthly Serum Sample (pdf, 48 KB)
Request for Tissue Typing, Solid Organ Recipient Testing (pdf, 46 KB)
Request for Tissue Typing, Solid Organ Donor Testing (pdf, 44 KB)
Request for Tissue Typing, Bone Marrow Transplant Patient Testing (pdf, 51 KB)
Request for Tissue Typing, Bone Marrow Transplant Donor Testing (pdf, 263 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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