Blood Donor Registration Blood Donor Registration

Kindly read the Eligible criteria before fill the form: Click here
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Persons with the following conditions are not eligible to donate blood
Malaria (within 1 year)
Hepatitis B, C *
Any other type of Jaundice (within 16 years)
AIDS
Tuberculosis (within 2 years)
Diabetes (are you under medication currently?)
Fits/ Convulsions (are you under medication currently?)
Cancer *
Leprosy or any other infectious diseases
Any allergies (Only if you are suffering from severe symptoms)
Hemophilia/ Bleeding problems *
Kidney disease *
Heart disease *
Chicken Pox (within 1 year)
Hormonal disorders *
Hemoglobin deficiency / Anemia (recently)
Drastic weight loss (recently)
Small Pox Vaccination (within the last 3weeks)
Blood Donation (within the last 3 months)
Blood Transfusion (within the last 6 months)
Major Surgery (within the last 3 months)
Pregnancy (within the last 6 months)
Organ Transplant (within one year)
  • We are very glad that you want to signup as donor.
  • We remind you of your responsibilities because you carry hope for those in dire need.
  • To register as a blood donor is a responsibility.
  • Once you are a registered donor, implies that you will be glad or privileged to donate blood at all possible times.
We respect your privacy. We will never rent, sell or give away your email to any third party.
 
Future Login Information
 * Username
 * Password
 * Retype Password

Donor Information
 * Donor Name
 * Gender
 * Photo
 * Date of Birth

(Ex: YYYY-MM-DD)
 * Weight
 kgs
 * Blood Group
   Last Donation

(Ex: June 2008 or Before 3 months)
   Frequency

Contact Information
 * State
 * City
 * Mobile No
 * Phone No
 * Email
   Address
 * Zip Code
   Personal Message

Form Verification
 * Enter the code
I have read the eligibility criteria and confrim that eligible to donate blood. Important: I authorize the website to display my telephone number, e-mail ID and mailing address so that the needy could contact me, as and when there is an emergency. I will inform the website at info@usablooddonors.com as soon as I donate blood so that contact information/Last donation is updated.