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Blood Therapeutic Phlebotomy Form

Blood Therapeutic Phlebotomy Form

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Whole Blood unit 250 mL Volume may be adjusted by BSI based on patient weight. Double Red Cells if donor qualifies otherwise whole blood will be drawn Frequency and Duration of Phlebotomy One time only Weekly Every weeks Monthly 4 week intervals Additional Instruction if indicated Total number of Procedures Number of months Therapeutic prescription is valid Maximum 12 months Minimum Hemoglobin. BSI minimum is 11. 0 for whole blood or 12. 0 for double red cells. Do not permit phlebotomy if...
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