Blood Transfusion Consent Form

The Blood Transfusion Consent Form is a critical document used in hospitals, surgical centers, and hematology clinics to obtain informed consent before administering blood or blood products. Given the inherent risks associated with transfusions and the potential for religious or personal objections, this form ensures thorough documentation of patient understanding and authorization.

This template addresses the types of blood products that may be transfused (whole blood, packed red blood cells, platelets, plasma, and cryoprecipitate), associated risks including transfusion reactions, infection transmission, and allergic responses, and alternative options such as autologous donation, cell salvage, and volume expanders. It includes specific fields for documenting religious or personal objections and allows patients to selectively consent to or refuse specific blood products.

Essential for hospital transfusion services, operating rooms, oncology infusion centers, and emergency departments, this form helps medical facilities comply with Joint Commission standards and state regulations while respecting patient autonomy in decisions about blood product administration.