Transfusion Annual Renewal


Employee Number:
Date:

I have reviewed laboratory policies;

20.08.31 ADMINISTRATION OF BLOOD OR BLOOD COMPONENTS


I have read and understand these policies and agree to follow the instructions outlined
within. I will not deviate from the policy without express written authorization from the
Laboratory Medical Director or his authorized representative. I have been provided the
opportunity to have all of my questions answered and have no further questions.
I request further training

Bring this form to the laboratory to complete the annual training for issuing a unit of blood or blood components.

Annual Training for ussing a unit of blood has been completed succesfully.

__________________________________________________________________________________________________
Signature Clinical Staff

__________________________________________________________________________________________________
Signature of Laboratory Personel


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