Take the donor eligibility screening questionnaire

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Home
+About
+Patients & Visitors
+Departments
- +Administration
- +Clinical and Allied Health Services
+Education & research
- Publications
- Video Center
Careers
+E-Services
-SQUH Blood Bank
+COVID-19
- Educational Posters
- Research Video

Blood Donation
Donor eligibility questionnaire
- Take the donor eligibility screening questionnaire
Donor Educational Material
What happens to my blood after donation
Where to donate blood & working hours
Contact us

Take the donor eligibility screening questionnaire

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Step 8

Personal Info

ID No: *
Name: *
Email: *

Q1

Is your weight less than 50 kg ? : *

YES NO

Q2

In the past 3 months, have you donated blood, platelets or plasma in any blood bank? : *

YES NO

Q3

Are you currently taking any antibiotics?: *

YES NO

Q4

In the past year, have you traveled to any malaria-endemic area(e.g. India, Pakistan, Africa)?: *

YES NO

Q5

Have you ever had malaria?: *

YES NO

Q6

In the last 14 days, have you had a COVID infection or been in contact with a patient with COVID?: *

YES NO

Q7

Female donors: Have you been pregnant or are you pregnant now?: *

YES NO

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