UWIBDF Twenty-Fifth Voluntary Blood Drive Appointment
Thank you for your interest in attending the UWI Blood Donor Foundation Twenty-Fifth Blood Drive on Saturday 17th September, 2022. Please make an appointment by selecting the time that you would be available on the day. Complete the questionnaire so that we can do our best to ensure that the process runs smoothly for you.

Note that due to the COVID-19 regulations there is a restriction to the number of people who can register for each time slot.

Leave a mobile phone number as we will be communicating with you via WhatsApp.

If you have any problems filling out this form, contact 390-1611 to make an appointment.

Donors registering for the 3:00 - 4:00 PM time slot, please try to arrive at 3:00 PM so that you can be registered in time.
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电子邮件地址 *
1) First Name *
2) Last Name *
3) Time *
4) Mobile phone number *
5) Gender *
6) Date of Birth- Date *
7) Date of Birth- Month *
8) Date of Birth- Year *
9) General Area of Residence *
10) Did you ever donate blood at the Eric Williams Medical Sciences Complex (Mt. Hope hospital)? *
11) If you answered yes to question 10, please indicate the date or general time period when you last donated at the Eric Williams Medical Sciences Complex.
12) Would you have mobile data on the day of the blood drive (September 17th)? *
13) What form of transport will you be using to arrive at the blood drive? *
14) If you are getting a drop with a private vehicle, would you be able to wait on your turn in the vehicle or would you need to proceed to the waiting area on arrival?
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15) Will you be arriving with someone who also plans to donate at the blood drive? *
16) If you answered yes to question 15, please indicate the donor's name(s) below.
17) If there are any specific issues that you would like us to know about, please indicate below.
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