offline LinkedIn PLASMA Donation Form
Please note offline LinkedIn is a community group of volunteers and we are trying to help people during this pandemic, We are not associated or involved in any kind of monetary activities and this form you are going to fill is on your own free will to help people who needs Plasma because they are suffering from COVID-19.

YOU CAN DONATE PLASMA IF:

1. You were tested positive for COVID-19
2. You have fully recovered and are free of symptoms for 14 days
3. You are between 18-60 years old

YOU CANNOT DONATE PLASMA IF:

1. Your weight is less than 50 kg
2. You have ever been pregnant
3. You are diabetic on insulin
4. Your Blood Pressure is more than 140 and diastolic less than 60 or more than 90
5. You have uncontrolled diabetes or hypertension with change in medication in last 28 days
6. You are a Cancer Survivor
7. You have chronic kidney/heart/lung or liver disease.
Donor Name *
Donor Age *
Blood Group *
Gender *
Donor Phone *
City *
Date of Positive Covid Test *
MM
/
DD
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YYYY
Date of Negative Covid Test
MM
/
DD
/
YYYY
Weight (kg) - Should not be below 50kg *
Do you have any of the following pre-existing conditions? *
How would you like to get communicated? *
Can your number be shared with an External Connect Looking for Plasma or only by Volunteer *
I am voluntarily registering as a plasma donor. I have read the eligibility criteria and confirm that I am eligible to donate plasma blood. I authorize offlineLinkedIn.com to display my Name, Mobile number to the person who is in need of plasma. I am donating plasma out of my free will and volition and accordingly release offlineLinkedIn.com and all organizers, trustees, volunteers and assistants in this project from any and all injury whatsoever and waive all rights to compensation and/or damages in case of injury or loss. *
Required
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