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Premonition Screening Form Page 1 of 5IdentificationI am the:RAMQ Egg DonorFirst Name Sperm Contrast Name SurrogateDate of Birth (YYY/MM/DD) Gender Hospital Card Number:MRC_OperationsFORMSFRM_DON_PreDonation_Screening_05172024_EN_v3.docxGeneral
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How to fill out pre-donation screening form

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How to fill out pre-donation screening form

01
Obtain pre-donation screening form from blood donation center.
02
Fill out personal information including name, date of birth, and contact information.
03
Provide details about medical history including any previous illnesses, medications, or surgeries.
04
Answer questions about recent travel to foreign countries or exposure to infectious diseases.
05
Agree to consent statement regarding donation and use of blood products.
06
Submit completed form to staff for review and approval.

Who needs pre-donation screening form?

01
Individuals who wish to donate blood or blood products need to fill out a pre-donation screening form.
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The pre-donation screening form is a form used to collect information from individuals prior to donating blood or organs.
Individuals who are planning to donate blood or organs are required to file the pre-donation screening form.
The pre-donation screening form can be filled out by providing accurate and complete information about medical history, current health status, and contact information.
The purpose of the pre-donation screening form is to ensure the safety of the donation process by screening for potential health risks or contraindications.
The pre-donation screening form should include information about medical history, current health conditions, medications, and contact details.
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