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
Approximate Risks per Unit of Transfused Allogeneic Blood Products
Therapeutic Phlebotomy Prescription Form

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.

 

Translate »