Requirements

Before You Use Donor EXPRESS

Please complete the form below and review the blood donor educational materials and list of medications/countries provided.

PLEASE CLEAR YOUR PHONE’S CACHE BEFORE COMPLETING DONOR EXPRESS to ensure you’re using the most up-to-date version of Donor EXPRESS so that your questionnaire works for your donation.

• After answering the health history questionnaire, you’ll receive a QR Code that you must present to your screener.
• Save, download, or screenshot the QR Code and show it to your screener on your smartphone or tablet.
• You may opt to print the code and bring it with you to your donation.
• Your answers online are not stored or transmitted to your donor record.

If you’re unsure whether you’re eligible to donate, review the Can I Donate? page before you proceed. You may also check out our Donor EXPRESS frequently asked questions (FAQs). If Donor EXPRESS won’t work for you, please come in to donate anyway! Your blood donation is needed, and you’ll be able to answer the questionnaire when you arrive.

• Donor EXPRESS must be done the same day you donate.
• Scroll down to fill out the form.
• All boxes must be checked before you enable “Go to Questionnaire.”
• Photo ID is required to donate.

Let’s get started! Please verify:

First Name *

* Please enter your first name.

Last Name *

* Please enter your last name.

Birthdate (mo/da/year) *

* Please enter your birthdate.

Gender * Male Female

* Please select your gender.

*

I am completing this questionnaire on the day of my blood donation.

* The questionnaire must be completed the same day as your donation.

Donor EXPRESS can only be used after 12:01 a.m. on the EXACT day you plan to give.

*

I am in a private setting and will answer the questions without input from anyone else.

* The questionnaire must be accurately completed by only you.

You will be able to review and change your answers, if necessary, as you complete the health history. If some questions are not answered, the form cannot be used.

*

I have reviewed the list of blood donor educational materials and am prepared to answer a question regarding it.

* The donor education materials will be needed during the questionnaire.

The blood donor educational materials will be referred to during the questionnaire. Clicking the box or the blue link will open these materials in a new window. Please do not close the window until you have completed the questionnaire.

*

I have reviewed the list of medications/countries and am prepared to answer a question regarding it.

* The medication / countries list will be needed during the questionnaire.

The medication / countries list will be referred to during the questionnaire. Clicking the box or the blue link will open these materials in a new window. Please do not close the window until you have completed the questionnaire.

* Required Field

Your responses are not saved.
You may be required to answer a question again.

Donor EXPRESS

• Requirements
• FAQs

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