Outpatient Transfusion Clinic

The Medical Day Care Unit at the Perth site of the Perth and Smiths Falls District Hospital supports stable out-patients with non-urgent treatment needs. Patients must be able to transfer independently, toilet themselves and should be able to tolerate sitting for the duration of treatment. Clinic staff will do their best to accommodate short notice treatments but may not always be able to do so.

Orders are accepted from physicians/providers with ordering privileges at Perth and Smiths Falls District Hospital.
A physician order is required, including two patient identifiers and a current phone number the patient can be reached at for clinic bookings. Lumeo Providers within the Lumeo system must enter an electronic order in Power Chart. The order must be attached to an active PSFDH encounter. Other Providers: A written order must be faxed to 613-267-2041.
A completed Informed Consent for Transfusion of Blood and Blood Products must be signed by both the patient and the provider. This must be faxed to the clinic prior to the patient’s visit.
Immune Globulin – the required MOH Request form must be completed. Lumeo Providers: The MOH Request Form must be completed in Cerner. Other Providers: The completed MOH IVIG Request form must be completed and faxed prior to the patient's visit.