Reaction Report Form

To assist its service hospitals in the delivery of patient care, ImpactLife utilizes the AABB standardized form for the purpose of tracking and recording all reactions associated with blood transfusion.

Please complete the Adverse reaction form below and email to 2-Quality@impactlife.org.

Reaction Report Form

Please note: US COVID Plasma EAP Hospital Blood Bank Transfusion Reaction Reporting Requirements The hospital blood bank is required to send a report to uscovidplasma@mayo.edu and  2-Quality@impactlife.org for any transfusion-related reaction that occurs for patients enrolled in the EAP that receive convalescent plasma.