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Date:KIDNEY TRANSPLANT PROGRAM DONOR PERSONAL HISTORYNAME:First. I.DOB:Handmaiden NAME:/PREFERRED NAME:ADDRESS:SSN: CityStateHOME PHONE: ()CELL PHONE: ()Zip Code Call priority #)WORK PHONE: (# RACE: HEIGHT:WEIGHT: email
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How to fill out donor personal history

01
Start by gathering all the necessary information such as name, date of birth, and contact details of the donor.
02
Begin by asking the donor about their medical history, including any past illnesses, surgeries, or chronic conditions they have experienced.
03
Inquire about the donor's lifestyle habits such as smoking, alcohol consumption, and any recreational drug use.
04
Request information on the donor's family medical history, including any genetic disorders or hereditary conditions present in their close relatives.
05
Ask the donor about their travel history, specifically in relation to any regions or countries where certain infectious diseases may be prevalent.
06
Inquire about any previous blood donations or transfusions the donor has had.
07
If applicable, ask the donor about their sexual history, including any high-risk sexual behaviors or history of sexually transmitted infections.
08
Finally, review the filled-out donor personal history form with the donor to ensure all information provided is accurate and complete.

Who needs donor personal history?

01
Donor personal history is needed by healthcare professionals, particularly those involved in blood donation services or organ transplantation.
02
Medical facilities and organizations responsible for screening and selecting suitable donors rely on personal history forms to assess the eligibility and safety of potential donors.
03
Furthermore, doctors, nurses, and other healthcare providers may also require donor personal history to evaluate the suitability of organ transplant recipients.
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Donor personal history is a document that contains information about an individual's health, lifestyle, and medical history that may be relevant to a donation.
Individuals who are donating organs or tissues may be required to file a donor personal history.
Donor personal history can usually be filled out online or on a paper form provided by the medical facility or donation organization.
The purpose of donor personal history is to ensure that the donation process is safe for both the donor and the recipient by providing relevant medical information.
Information such as medical conditions, medications, lifestyle habits, and family medical history may need to be reported on donor personal history.
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