Blood Donation e-Consent Form
Personal Information
Full Name
Date of Birth
Email Address
Mobile Number
Address
About the Donation
Have you donated blood before?
Yes
Date of last donation
Any known allergies or illnesses?
Are you currently taking any medication?
Consent
I have read and understood the information regarding blood donation provided to me in this app. I understand the purpose, procedure, benefits, and potential risks involved. I agree to proceed with blood donation voluntarily.
I agree and give my e-consent to donate blood.
E-signature (Type your full name)
Date