Facility Annual Return

  • Facility Annual Return

  • If your organization has multiple FINs:
    1.  Click on all applicable facility types and on the Activity section, enter aggregate numbers for all facilities associated with this registration.


    For example, Large University Medical Center (A9990) collects 23,000 units of whole blood each year. Bedford (A9991) collects 6,000; Centerville (A9992) 4,000; and Springfield(A9993) 2,000. For Whole Blood Units Collected, enter the total for the 4 hospitals (35,000).


    2.  Complete the main facility’s demographic information on the Facility Info section. Complete the demographic information on the ASSOCIATED FACILITY ANNUAL RETURN for each additional FIN. 


    For example, Large University Medical Center (FIN A9990) has three associated facilities under a single ICCBBA registration: Large University Medical Center – Bedford (A9991), Large University Medical Center – Centerville (A9992) and Large University Medical Center – Springfield (A9993). This organization should complete one facility annual return form for A9990, and the associated annual return form for EACH of the three other hospitals (Bedford, Centerville and Springfield).

  • Facility Info

  • Is your facility address the same as your billing/mailing address?
  • Facility Type (Check all that apply)*

  • Blood Facilities

    (e.g., apheresis, whole blood, pooling events)

  • DINs are assigned to each collection, pooling or apheresis event. This does not include cell therapy products

  • Cellular Therapy

    (e.g., apheresis, marrow, cord blood, adipose)
    • For facilities that only perform collections: The total number of Donation Identification Numbers (DINs) assigned annually. DINs are assigned to each collection/pooling event.
    • For facilities that only process units: The total number of final ISBT 128 labeled products distributed annually.
    • For facilities that both collect and process: Whichever annual total value is greater.

  • Tissue (Non-Ocular)

  • (Note: For tissues collected with intent of being processed into cellular therapy product please fill out cellular therapy collections.)

  • Tissue (Ocular)

  • (Note: For tissues collected with intent of being processed into cellular therapy product please fill out cellular therapy collections.)

  • HCT/P Medical Devices

  • Human Milk Banking

  • Plasma Fractionators

    • For facilities that assign Donation Identification Numbers (DINs): The total number of Donation Identification Numbers (DINs) assigned annually.
    • For facilities that label final products: The number of final products labeled annually with ISBT 128.

  • Assisted Reproductive Technology (ART) / Medically Assisted Reproduction (MAR) (Cells and Tissues) Facilities

  • Organ Transplant

  • Fecal Microbiota

  • Regenerative Medicine

  • Serum Eye Drops

  • Contact Details

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  • Should be Empty: