By using the forms, the data protection declaration is accepted.

Registration

When signing up with this prescription/order form, you are creating a legally binding registration through which you can request:
 

  • Apheresis (blood stem cell and Lymphocyte apheresis) as well as whole blood procurement for donor lymphocyte infusion (DLI) at the Institute for Transfusion Medicine, and
     
  • all processing methods approved by the Cellular Therapy Center.

Please fill in the form completely for the planning of sample procurement and/or for the required processing of externally collected preparation for the treatment of your patient, then send a signed copy by fax to the number indicated on the form.

Preparations can be delivered to the Cellular Therapy Center from Monday through Friday between 8 a.m. and 4.30 p.m.
 
Please do not hesitate to contact us at any time if you have any questions or if you wish to receive more information.

Request

When filling in this request form you submit a legally binding request, and can inquire about:
 

  • the status, and specifically the availability and physical integrity of the preparations already manufactured for your patient as well as 
     
  • the delivery of selected preparations for transplantation or infusion.
     

Make sure to fill in the form completely with the data relating to the planned preparations for the reconstitution before the start of the conditioning, then send a signed copy by fax to the number indicated on the form. You should use the same form to ask for the delivery of a preparation at least two working days before the planned transfer.

Preparations can be picked up from the Cellular Therapy Center from Monday through Friday between 8 a.m. and 4.30 p.m.
 
Please do not hesitate to contact us at any time if you have any questions or if you wish to receive more information.