Convalescent Plasma COVID-19 Donor Registration Form
Thank you for your interest in convalescent plasma donation and joining our mission to save lives. Please complete and submit the form below if:
- You have a lab-confirmed positive test for COVID-19 virus, OR a positive recovery test showing immunity
- Your symptoms have been gone for at least 14 days
- You meet the eligibility requirements to donate blood
- You are willing to donate plasma
All information provided will be kept confidential and will only be used to qualify you as a donor.
IMPORTANT REMINDERS:
- Documentation of a positive test is required to donate (can be provided upon submission of the below form)
- Results must be a non-editable document (text messages will not be accepted)
- Document must include your full name, testing facility or physician, test name, date, and result
- When presenting to donate, donors are asked to bring and wear a face mask or face covering
Please complete and submit this form:
*Required fields