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FORMS

Transplantation Record & Feedback Form (TRFF)

PLEASE COMPLETE ALL FIELDS BELOW

FDA Regulations and Joint Commission Standards require tissue tracking systems in all hospitals using allograft tissue for transplantation. In order to comply with these requirements, please complete ALL fields on this form.


Completion of this record at the time of graft usage is required by FDA regulations. We ask that your facility act responsibly by returning the completed record to JRF Ortho and maintaining a copy in the patient chart.

JRF Ortho does not consider the information requested on this form to be protected health information (PHI), as defined under the HIPAA regulations. Information considered to be PHI by the originator should not be released to JRF Ortho