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.

• Blood Component Emergency Storage List and Tempera
  ( DIST.04.F144 v3.0 )
• 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 )
• Special Donations Record
  ( DRS.04.F028 version 4.0 )
• PHYSICIAN’S AUTHORIZATION FOR THERAPEUTIC PHLEBOTO
  ( DRS.04.F190v5 )
• Donor Testing Laboratory Request
  ( DTL 04 F087 v.8 )
• REPORT OF SUSPECTED POST TRANSFUSION DISEASE (PTD)
  ( DTL.04.F212.v2.0 )
• Immunohematology Laboratory Request
  ( IMM.04.F001 v.5 )
• Platelet Antibody Laboratory Request
  ( IMM.04.F026 )
• Report of Suspected TRALI
  ( MED.04.F010 )