LifeStream is proud to offer the following services:
- Autologous donation
- Dendreon collection
- Directed donation
- Granulocyte collection
- Therapeutic collection
Requests for autologous or directed blood donations and therapeutic collections must be ordered using the applicable forms below.
For questions regarding our services, please contact a Medical Services Coordinator at 877.386.6874 or 909.885.6503 (ext. 664) or via email at MedicalServices@LStream.org.
Autologous Acceptability Criteria
Autologous Donation Protocol – a step by step guide
Request for Autologous Donor Blood Components
Directed Donation Protocol – a step by step guide
Request for Directed Donor Blood Components form
Therapeutic Phlebotomy Prescription Form
Forms have been recently updated, please ensure you’re using the October 24, 2018 version. If the link still pulls previous versions we recommend you do a complete page refresh (click Shift+F5).
Please fax completed forms to:
Additional Educational Materials
LifeStream offers a variety of education brochures – available for physicians – if you wish to receive copies of the brochures please place your order below.
Note: The signature of the ordering MD/DO, NP, or PA is required. Requests with the practitioner’s name signed or initialed by another individual or “stamped” signatures will be returned for an authorized signature.