AUTOLOGOUS BLOOD CONSENT FORM
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FOLLOWING IS A COPY OF AN AUTOLOGOUS BLOOD WITHDRAWAL CONSENT FORM TO BE SIGNED BEFORE BLOOD IS DRAWN AND STORED.

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This web page will present an Autologous Blood Consent Form. The form is used when a Blood donor wishes to donate Blood for their own use. The form identifies you positively, with your vital statistics. Further, the form enumerates your Blood profile, your exact Blood needs, the appx. date of the surgery for which the Blood is needed and information on the physician and the hospital, if any.

View a detailed explanation of Informed Consent HERE.


To be presented here will be a very small version of a typical Autologous Blood Consent Form (16 KB). You will then click on the image to view a near actual size image which can more easily be read. The larger image will take a while to load with a modem, and, when published will be appx. 70 KB period-red.gif (63 bytes)

AUTOLOGOUS BLOOD WITHDRAWAL CONSENT FORM - BloodBook.com!

View a detailed explanation of Informed Consent HERE.

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   last updated 11/10/2004   bloodbook.com