JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
MESAA Blood Donation Enrollment Form - 25th March 2022
This is an Enrollment Form to participate in the MESAA Blood Donation Campaign 2022. Please note that this form is restricted to Qatar residents only who are fully vaccinated against COVID-19.
* Indicates required question
Name
*
Your answer
Age
*
Your answer
Gender
*
Male
Female
Qatar Mobile Number
*
Your answer
Qatar Identity Number / Passport Number
*
Your answer
Blood Group Type
*
A+
A-
B+
B-
O+
O-
AB+
AB-
Did you travel to any other country in past 6 months (Sept 2021 to Feb 2022)
*
Yes
No
If yes, Please mention the country and the period travelled.
Your answer
Have you donated blood in the past 6 months
*
Yes
No
Would you be comfortable to donate blood on 25th of March 2022
*
Yes
No
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report
