Request cards order form

e-mail address: *

Sender name: *

Sender number: *

Type of card: *

please select Prescription - Request for blood products (blue) Prescription - Emergency order (gray) Laboratory service - Immunogenetics (red) Laboratory service - Immunohematology (green) Transfusion reaction (purple)

Package size: *

please select 20 40 50 100

Number of packs: *

please select 1 2 3 4 5 6 7 8 9 10

I have taken note of the following information obligations, which fully inform me about the use of the data provided via the contact form: My personal data will be stored and processed on the server of the MHH data center in accordance with data protection regulations, in particular the GDPR. The Institute of Transfusion Medicine and Transplant Engineering has access to the data. The processing of the personal data provided by me serves to order request cards. My personal data will be passed on to the processor for this purpose: color direct Medien Druckhaus GmbH Unterer Sundern 13 32549 Bad Oeynhausen. An order processing contract in accordance with Art. 28 GDPR has been concluded. My data will be stored after collection at the Institute of Transfusion Medicine and Transplant Engineering of the MHH for as long as necessary to fulfill the purpose. Existing retention obligations and periods will be observed. In the event of a revocation, my data that I have provided via the contact form will be deleted. In the data protection declaration linked below the form, I have taken note of my legal rights with regard to the personal data concerning me in accordance with the GDPR. *