Plasma Donation Form
Please fill this form to allow healthcare professional to get in touch with you to get plasma collected to save lives! Your data will not be shared with anyone else outside of certified and validated healthcare professionals!

Fill only if you have been tested, diagnosed with COVID19 and now at least of 14 days of being in recovery [no symptoms]. You must have a negative result on your follow up test for COVID.

The U.S. Food and Drug Administration (FDA) has updated its rules around use of experimental treatments for the ongoing COVID-19 pandemic to include use of “convalescent plasma,” in cases where the patient’s life is seriously or immediately threatened.

All donor patients would have to be tested to confirm that they are not at risk of transmitting the virus, and they must also qualify as a blood donor under the existing rules in place by state and federal agencies.

Email address *
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy