LifeStream

Welcome to LifeStream

PHYSICIAN SERVICES

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.

Printable Forms

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 May 11, 2018 version. If the link still pulls the April 2018 version we recommend you do a complete page refresh (click Shift+F5).

Please fax completed forms to:
Medical Services
Fax: 909.386.6817

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.

Order Materials Here

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.

 

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