Patient Services

Patient Care

ImpactLife provides patient care and services under the guidance of highly specialized doctors and clinical team members. This direct patient care occurs on site at select blood center facilities as well as on site at service hospitals. All treatments provided by ImpactLife require orders from the patients’ treating physician(s). We provide programs for:

TREATMENT OF:

• Hemochromatosis
• Late-stage prostate cancer with Provenge, a Dendreon medication 

CONDITIONS REQUIRING:

• Therapeutic Apheresis - Process of removing plasma or cells from blood to treat disease.
• Transfusion of Granulocytes - Dedicated donors who donate platelets frequently and are familiar with apheresis procedures are needed.
• Autologous Donation - Donation of one’s own blood prior to elective surgery
• Directed Donation - Donation of blood intended only for one patient (donor usually knows the patient).
• Designated Donation - For donors where additional screening of their blood has identified them  as a better match for a specific patient (donor does not know the patient).

forms for download

• A-413 Notice of Privacy Practices
• P-310 Directed Donation Position Statement *
• P-156 Autologous Donation Order Form *
• P-020 Directed Donation Order Form *
• P-176 Physician Request for Therapeutic Phlebotomy (Doctor office fills out page 1 and sends to ImpactLife to complete page 2)
• P-857 Transfusing Facility Physician Order Form for Granulocyte Products

*Autologous and Directed donation requests are now electronic. Please reach out to your hospital’s transfusion service department for details regarding the ordering process.

contact

For more information, please contact our Patient Services Department at (563) 823-4132 or email patientservices@impactlife.org.