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Name
Address
Date of Birth
Is this your first time donating?
In the last six months have you had any of the following?
In the last 72 hours have you taken any of the following?
Clear Signature
By signing this form you consent to the disclosure of personal health information such as age, donation history, and blood type.

Do you need a place where potential blood donors can sign up for donation directly on your WordPress website? Try the Blood Donation Form Template from WPForms. You can edit the form to fit your organization’s need and embed it on your site to begin screening blood donors.

Why Use a Blood Donation Form Template?

When collecting information for blood donation, it’s vital that the data received is accurate and secure. It’s also important that the questions asked of potential donors will provide the answers needed to determine donor eligibility.

That’s why our Blood Donation Form Template contains the fields already in place that you’d want on a blood donation form.

First, the form collects the name and contact information from the potential donor.

Birthdate is entered next, which helps you to determine whether or not this donor has met the age requirement to give blood.

Then, donors are asked to provide their blood type, donation history, and recent medical history.

This template also requires a signature from potential donors to provide their consent for disclosing this information.

Additionally, like all of the form templates from WPForms, this Blood Donation Form Template is incredibly easy to edit with our user-friendly form builder.

You may decide to include additional screening questions for potential donors, and the process takes only a few minutes to complete. If you want to add or remove any fields or questions on your blood donation form, you can do so directly on the form template, without the need for coding. Simply drag-and-drop the fields with the click of your mouse to customize the form as you see fit.

Get started with WPForms today to create and customize your own blood donation form. Signing up with WPForms gives you access to this and hundreds of other pre-made templates.