Online Forms

Community Blood Center serves over 70 hospitals in over 70 counties in Missouri and Kansas.

In an effort to provide quality service to our hospital and laboratory clients, the following forms have been posted. If there is a form that you would like posted online, please call Hospital Relations at (816) 753-4040 or send an email Pat Parton.

To download the form, you must have the FREE Adobe Acrobat Reader. The forms are in Portable Document Format. To download the FREE Adobe Acrobat Reader, click here.

Note: Every effort will be made to make sure these forms are the most current versions. However, they are subject to change without notice. If there is a form not listed here that you think should be posted, please send an email or call (816) 968-4419.

• AABB Certificate of Accreditation for Facility
  ( AABB Accreditation 2014 )
• AABB Certificate of Accreditation for Laboratory
  ( AABB Cert. DTL )
• Transfusion Reaction Information Record
  ( CBC.040F245 v1 )
• Hereditary Hemochromatosis services
  ( CBC.05.B1007 v 2.0 )
• About Your Blood Transfusion
  ( CBC.05.B1011 v2.0 )
• CLIA Certificate of Accreditation for CBC-DTL
  ( CBC.06.CLIA-3 v4 )
• Donor Testing Laboratory Requisition
  ( CBC.06.F001v1 )
• CLIA Certificate of Accreditation for 4040 Main F
  ( CLIA-KC.2013 )
• CLIA Certificate of Accreditation for All the Fix
  ( CLIA-KLN.2013 )
• Blood Component Emergency Storage List and Tempera
  ( DIST.04.F144 v4.0 )
• ORDER & AVAILABILITY FAX FORM
  ( DIST.04.F221 v.3 )
• Returned or Transferred Blood Products
  ( DIST.04.F231 V 2.0 )
• Unsuitable Blood Products
  ( DIST.04.F232 V 2.0 )
• Blood Donor Parent/Guardian Consent Form
  ( DRD.04.F018 v6.0 )
• Special Donations Record
  ( DRS.04.F028 version 4.0 )
• PHYSICIAN’S AUTHORIZATION FOR THERAPEUTIC PHLEBOTO
  ( DRS.04.F190v6 )
• FDA Blood Establishment Registration & Product Lis
  ( DTL - FDA cert..pdf )
• FDA Blood Establishment Registration & Product Lis
  ( FDA Certificate of Accreditation for CBC-KC )
• Immunohematology Laboratory Request
  ( IMM.04.F001 v.5 )
• Platelet Antibody Laboratory Request
  ( IMM.04.F026 )
• Report of Suspected TRALI
  ( MED.04.F010 v5.0 )
• REPORT OF SUSPECTED POST TRANSFUSION DISEASE (PTD)
  ( MED.04.F043.v1 )