The following forms are used for routine CTR reporting:
| Forms |
Dated |
|
Used for changes to CTR data |
Mar 2011 |
|
IM.006F - Interhospital Exchange Form Used for product shipments without a patient |
April 2018 |
|
IM.007F - Interhospital Exchange Form Used for blood product transport with a patient |
April 2018 |
|
IM.003F - Blood Product Issue and Transfusion Record Used to manually report transfusion records |
Apr 2009 |
|
IM.005F - Component and Fractionated Blood Product Discard Record Used to manually report discarded records |
May 2009 |
The following items are available to order through the PBCO:
• IM.003F Blood Product Issue and Transfusion Record
• IM.005F Component and Fractionated Blood Product Discard Record
• Code C Address Labels
Please email This email address is being protected from spambots. You need JavaScript enabled to view it. to order.
