Penn-Jersey Blood Services Region Request Forms
Hospital customers may download any of the following forms: (Forms require Adobe Acrobat)
We provide hospitals in New Jersey, southeastern Pennsylvania and Delaware with lifesaving blood products 24 hours a day, 365 days a year. Our reference laboratories for red cell and platelet serology help blood centers and hospitals resolve difficult serologic problems, and locate and ship rare blood products for transfusion. We are also there when patients need special products like granulocytes and HLA-matched platelets. Physicians and technical experts are available for consultation around the clock.
Our more than 700 employees are dedicated to meeting all patient needs with a reliable blood supply that is as safe as possible.
The Transfusion Service Customer Handbook
Product Request Forms available include:
- Physician Authorization Letter for Releasing IRL Results to Health Care Facilities
- Urgent Release of Test Results
- Immunohematology Consultation Request Form
- Immunohematology Consultation Request Instructions and Checklist
- Credit Request for Products - Non Physical Return Form
- Request for Platelet Serology Testing
- Request for Neutrophil Serology Testing
- Request for Neonatal Testing
- Molecular Testing Request Form
- Histocompatibility Testing Requisition