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Get the free Donor Medical and Social History Questionnaire

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CSF914 GLN ID #: ___Complete this box for Pediatric Donors ONLY: Donor MaternalTrillium Gift of Life Network 483 Bay Street South Tower, 4th Floor Toronto, Ontario M5G2C9 Telephone (24/7): 1.877.363.8456
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How to fill out donor medical and social

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How to fill out donor medical and social

01
Collect detailed medical history of the donor including past medical conditions, surgeries, medications, and allergies.
02
Gather information about the donor's social habits such as smoking, alcohol consumption, and recreational drug use.
03
Record any relevant family medical history that may impact the donor's health.

Who needs donor medical and social?

01
Medical professionals who are treating the donor or potential recipients of the donor's organs or tissues.
02
Medical researchers studying the impact of medical and social factors on health outcomes.
03
Organ donation organizations and agencies facilitating the matching process between donors and recipients.
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Donor medical and social refers to the documentation that collects medical history and social information about a potential organ or tissue donor. This includes past medical conditions, medications, risk factors, and lifestyle choices that may impact eligibility for donation.
Healthcare providers and organizations involved in the procurement of organs and tissues are required to file donor medical and social information. This includes transplant centers and organ procurement organizations.
Donor medical and social forms should be filled out by trained healthcare professionals who conduct interviews and medical assessments of the donor. They must accurately record the donor's medical history, social history, and other relevant information as instructed on the form.
The purpose of donor medical and social is to assess the eligibility of an individual for organ or tissue donation, ensure the safety and efficacy of transplants, and to provide vital information for matching donors with recipients.
Information that must be reported includes the donor's medical history, current medications, risk factors for infectious diseases, psychosocial information, and any other factors that may affect the donation process.
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