Blood/Plasma Donor Form
This is the form to collect details of all the eligible donors,

- Recovered from COVID between Jan - April
- Should be in the 18 - 60 age group
- Should weigh at least 50 kilograms
- It's been 15 days post recovery and 28 days should've passed since last vaccinated for COVID

One cannot donate Plasma if:

- Have ever conceived
- Diabetic and on insulin.
- Have hypertension with a change in medication in the last 28 days.
- Have issues related to liver, kidney, lung, etc.
Sign in to Google to save your progress. Learn more
Name *
Age *
Blood Group *
Locality *
City *
Contact Number *
Recovered from COVID on *
MM
/
DD
/
YYYY
Vaccinated *
Willing to Donate *
Blood
Plasma
Both
Open to donate
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms