Background: Iron chelation therapy (ICT) is an essential medication for people with thalassemia and other hematological disorders requiring long-term red blood cell transfusion to minimize the risk of iron overload. Suboptimal adherence to iron chelation medication is prevalent and has been associated with increased risk of iron overload, resulting in increased morbidity, mortality, and healthcare utilization. Widespread use of personal technology makes mobile health (mHealth) an attractive platform to promote adherence. Aims: The objective of this study was to examine access to mobile technology and preferences for an mHealth intervention to improve adherence to ICT. Methods: This is an analysis of a cross-sectional survey that was administered through REDCap using tablets during pRBCs transfusion visits at Ann & Robert H. Lurie Children’s Hospital of Chicago. Parents of children receiving chronic transfusions, as well as adolescents and young adults (AYAs) receiving chronic transfusions were enrolled between August 2018 and June 2019. Patients had to have a hematologic diagnosis requiring chronic transfusions, be on an iron chelation therapy, and be 12 years or older to complete the survey. Parents were required to have a child older than 24 months who met these criteria. Results: A total of 60 participants were included (median age [IQR] 31.5 [20-39]; female, 36.7% [40/60]), with a total of 29 parents and 31 patients. The most endorsed mHealth app features among participants, both parents and patients, included laboratory monitoring (91.7%, 55/60), reminders to take ICT (83.3%, 50/60), and education about ICT (81.7%, 49/50). In particular, parents’ most endorsed features included laboratory monitoring (93.1%, 27/29), and education about ICT (86.2%, 25/29) (Figure 1). On the other side, AYA’s most endorsed features included laboratory monitoring (90.3%, 28/31) and reminders to take iron chelation medication (90.3%, 28/31) (Figure 1). There were no significant differences between parents and patients in their preferences, although there was a trend towards a greater proportion of patients compared to parents who preferred positive feedback in the form of encouraging messages when taking medications as an app feature (87.1% vs. 68.96%, p =0.09). Conclusions: Parents and AYAs reported a strong interest in multiple mHealth app features. Participants provided valuable insight into optimal strategies and preferred app features for developing a multifunctional technology-based behavioral intervention (mHealth app), to promote ICT adherence for AYA with thalassemia or other chronic-transfusion dependent conditions.