FDA Tissue Tracking

Completion of this record at the time of graft usage is required by FDA regulations. FDA requires patient records to be properly maintained by storing the allograft LOT NUMBER for purposes of tracking the allograft from the donor to the recipient. We ask that your facility act responsibly by providing the information below and maintaining a copy in the patient file. Upon completion you will receive an email confirmation that includes the information provided.

Transplant Facility Information

Recipient Information

Date of Surgical Procedure