Your complete honesty in answering all questions is very important for
the safety of patients who receive your blood.
All information you provide is confidential.
DONATION PROCESS:
To determine if you are eligible to donate we will:
-Ask questions about health, travel, and medicines
-Ask questions to see if you might be at risk for hepatitis,
HIV, or AIDs
- Take
your blood pressure, temperature and pulse
- Take a small blood sample to make sure you are not anemic
If you are
able to donate we will:
- Cleanse your arm with an antiseptic. (If you are allergic to Iodine, please tell
us!)
-Use a new, sterile, disposable needle to collect your blood
Sexual contact may cause
contagious diseases like HIV to get into the bloodstream and be spread through
transfusions to someone else.
Definition
of “sexual contact”:
The words “have sexual contact
with” and “sex” are used in some of the questions we will ask you, and apply to
any of the activities below, whether or not a condom or other protection
was used:
1. Vaginal sex (contact between penis and vagina)
2. Oral sex (mouth or tongue on someone’s vagina, penis, or anus)
3. Anal sex (contact between penis and anus)
AIDS is caused by HIV. HIV is spread mainly through sexual contact with an infected person OR by sharing
needles or syringes used for injecting drugs.
DO NOT DONATE IF YOU:
-Have AIDS or have ever had a positive HIV test
-Have ever
used needles to take drugs, steroids, or
anything not prescribed by your doctor
-
Are a male who has had sexual contact with another male, even once, since 1977
- Have
ever taken money, drugs or other payment for sex since 1977
-
Have had sexual contact in the past 12 months with anyone described above
- Have had syphilis or gonorrhea in the past
12 months
- In the last 12 months have been in juvenile
detention, lockup, jail or prison for more than 72 hours
-Have
any of the following conditions that can be signs or symptoms of HIV/AIDS:
·Unexplained weight loss or night sweats
·Blue or purple spots in your mouth or skin
·Swollen lymph nodes for more than one month
·White spots or unusual sores in your mouth
·Cough that won’t go away or shortness of breath
·Diarrhea that won’t go away
·Fever of more than 100.5 oF for more than
10 days
Remember that you CAN give
HIV to someone else through blood transfusions even if you feel well and have a
negative HIV test. This is because tests cannot detect
infections for a period of time after a person is exposed to HIV. If you think you may be at risk for
HIV/AIDS or want an HIV/AIDS test, please ask for information about other
testing facilities. PLEASE DO NOT DONATE TO GET AN HIV
TEST!
Blood donor
tests may not be available for some contagious diseases that are found only in
certain countries. If you were born in,
have lived in, or visited certain countries, you may not be eligible to
donate.
To protect patients, your blood is tested for hepatitis B
and C, HIV, certain other viruses, and syphilis. If your blood tests positive
it will not be given to a patient. You
will be notified about test results that may disqualify you from donating in
the future. Please do not donate to
get tested for HIV, hepatitis, or any other infections!
Thank you for donating blood
today!
(Donor Center Name)
(Telephone
Number)