Following discussion with the patient, the physician may request this service by
completing and submitting a physician order form that is usually required by blood
centers prior to scheduling the first donation appointment. To ensure proper labeling of
the autogeneic unit, the order form must include: patient’s full legal name (as to be used
during the hospitalization); date of birth; date of anticipated transfusion; name and
address of the hospital where the surgery will be performed; and the ordering physician’s
name, address, and telephone number