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Plasma Donor Registration
This initiative is for a social cause. By filling this form, you confirm to share your contact information with potential seekers. We will try and ensure we’re sharing data responsibly, however, cannot be held liable for misuse of information. This initiative is voluntary and will facilitate getting donor and person in need connected and we are nowhere involved in collecting plasma samples nor intend to derive commercial gains
Email *
Donor's City *
Your Name *
Your Mobile number *
Donor's name *
Your alternate OR Donor's mobile number
Did Donor have covid in past? *
Would Donor want to donate plasma? *
Donor's last covid recovery date *
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Donor's Locality Name *
Donor's Blood Group *
Date plasma donated last time by Donor
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Preferred timeslot for Plasma donation during weekdays
Is Donor Ok to have antibody test if recovery more than 90 days old
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Any known history/conditions that would stop Donor from donating plasma https://www.icmr.gov.in/pdf/covid/techdoc/ICMR_ADVISORY_Convalescent_plasma_17112020_v1.pdf Donor ineligible for convalescent plasma donation - 1. Weight less than 50 kg 2. Females who have ever been pregnant 3. Diabetic on insulin 4. B.P more than 140 and diastolic less than 60 or more than 90 5. Uncontrolled diabetes or hypertension with change in medication in last 28 days 6. Cancer Survivor 7. Chronic kidney/heart/lung or liver disease.
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Any remarks or comments
A copy of your responses will be emailed to the address you provided.
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