Therapeutic Phlebotomy (Medically Required Phlebotomy)

Program has been revised. Please read carefully for recent changes in enrollment and payment.

The individuals in this program require a blood withdrawal to treat a medical condition. They have been diagnosed with a blood disease or disorder, like polycythemia vera or porphyria cutanea tarda. They DO NOT meet donor eligibility criteria because of their diagnosed medical condition.

Individuals on Testosterone Replacement Therapy or diagnosed with Hereditary Hemochromatosis should go to our Testosterone Replacement Therapy or Hereditary Hemochromatosis pages for information on these programs.

Enrollment Process:

To begin, a Enrollment/Prescription for Phlebotomy From must be submitted by your physician. The physician must disclose the diagnosis requiring phlebotomy and any other health concerns (infectious disease or heart/lung issues). This form must be mailed, emailed, or faxed to our office prior to scheduling your first appointment. It may be renewed each year by your physician, as needed.

The Therapeutic Donation Form must be filled out completely and signed by the physician. Please do not alter the form, as this will delay enrollment. The form is valid for 12 months from the date signed by the physician.

This is a donor driven program; you and your physician will determine how often you need to be drawn. Our program allows blood draws as often as every two weeks (14 days) to allow flexibility and to accommodate everyone’s needs. Carter BloodCare does not monitor frequency beyond a minimum of 14 days between phlebotomies.

The donor may either complete the top portion of the Therapeutic Donation Form and forward it to their physician for signature or ask their physician to send the completed form to Carter BloodCare’s Donor Notification Department.

You will be notified by mail or email once your enrollment is complete. Once enrolled, you may call our Contact Center to schedule your appointments. Walk-ins are NOT allowed.

Some health conditions may exclude you from being drawn at Carter BloodCare. If a history of cardiac and/or lung conditions, cancer or HIV applies to you, please call Donor Notification at (817) 412-5308 or email us at dn@carterbloodcare.org. Donor Notification will be able to address your concerns.

There is an associated fee with this program.

Money Order, Traveler’s Check or Cashier’s Check for the exact amount must be presented to the Donor Center staff at the time of the blood withdrawal. Cash or credit cards will NOT be accepted. Donor Center staff will provide you with a receipt.

For any questions, you can reach Donor Notification weekdays from 9am – 5:30pm at (817) 412-5308 or email  dn@carterbloodcare.org.

1. Enrollment/Prescription for Phlebotomy Form to be completed and signed by physician.
2. Submit completed form to dn@carterbloodcare.org or fax to (817) 412-5318.