Special Requests for Donation

Designated Donors

These are donors that donate blood to be used for a specific patient who is scheduled for surgery or for a transfusion. The donation will be held for the intended recipient if it is compatible and if the donor meets all eligibility requirements. (We do not prescreen donors for blood type.)

• Please note that you are a designated donor on the attached Request for Donation Form
• Please come to the Blood Donor Center with the full name of the intended patient AND the Social Security number of the patients (so that the donation can be linked)
• Remember to bring a personal photo ID

Autologous Donors

These are donors who are donating for their own use at a later date (usually scheduled surgery).

• Please note that you are an autologous donor on the attached Request for Donation Form.
• If you are 75 years and older, you MUST have a letter of medical clearance for donation from your physician.
• If you have a history of heart disease, you MUST have a medical clearance for donation from your physician.
• Your referring physician MUST send a completed “Autologous Blood Donor Program Order Form” to the Blood Donor Center.
• Remember to bring a personal photo ID

Therapeutic Phlebotomy

These are patients who have been referred to the Blood Donor Center for donation because of a specific medical diagnosis.

• Please note the diagnosis and your referring physician’s name under comments on the Request for Donation Form.
• Your physician must complete the following forms:
  • Request for Therapeutic Phlebotomy,
  • Request for Serial Therapeutic Phlebotomies,
  • Request For Therapeutic Phlebotomy for Hemochromatosis Patients (if appropriate)