What specific health screening fields should I include in my blood donor application?

You can add custom fields to track blood type, recent travel history, current medications, and any existing health conditions that would affect donation eligibility.

How can I organize donors by blood type once the forms are submitted?

You can use the software to tag or categorize applicants based on the blood type they entered in the form, making it easier to call specific donors during an emergency.

Can I add a section for donor emergency contacts to the blood donor application?

Yes, the template is fully customizable, allowing you to add a dedicated section for emergency contact names and phone numbers for every donor.

How do volunteers access the form during a community blood drive?

You can set up a tablet as a kiosk at your event or share a QR code that donors can scan to complete the application on their own smartphones.

Can I embed this application directly onto my charity's website?

Yes, you can embed the form on your 'Get Involved' or 'Donate' page so potential donors can apply without leaving your site.

Is it possible to add my organization's branding to the donor form?

You can upload your non-profit's logo and adjust the colors to match your organization's brand identity before sending the form to applicants.

Blood Donor Application Form

This blood donor application form allows non-profits and community health groups to collect medical history and contact details from individuals volunteering to donate blood.

Created by Marcus Bell · Compliance writerUpdated Jun 19, 2026

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Application

Blood Donor Application Form

Please use this form to apply to join our blood donor registry. We ask that you provide all requested health and contact details accurately; please note that submitting this application is a request to become a donor and does not guarantee your eligibility or acceptance into the program.

Applicant details

Full legal name*

First name

Last name

Email address*

Phone number

Date of birth

Address

Street address

City

State / province

ZIP / postal code

Blood type

Weight (kg)

Last donation date

Medical conditions

Certify & submit

I certify that all information provided in this application is true, complete, and accurate to the best of my knowledge. I understand that this data will be used to evaluate my medical eligibility to donate blood and that any omissions or misrepresentations may disqualify me from the donor list. I hereby consent to the verification of the health information provided and agree to undergo any necessary screenings required to ensure the safety of the blood supply and the donor.

By signing below, I acknowledge that I have read this application in its entirety, that the information I provided is correct, and that I am submitting this request voluntarily (and, if I am under 18, with the full knowledge and consent of my parent or legal guardian).

I certify the information above is true and complete and submit this application.*

Signature*

Sign here

Date*

About this template

The Blood Donor Application Form is a digital template designed to collect essential health and contact information from potential blood donors. You can customize the fields to match your specific intake requirements and add your organization's branding. Once configured, you can share the form via a direct link, embed it on your website, or set up a tablet kiosk for in-person registration.

Donor contact information
Blood type and medical history
Emergency contact details
Eligibility questionnaires
Availability and scheduling preferences
Digital signature field

Non-profit organizations, community blood drives, and volunteer coordination centers use this form to build a reliable database of eligible donors. It streamlines the screening process by moving the initial application phase online. This allows organizers to manage donor lists and coordinate blood drive schedules more efficiently.

Questions about this waiver

What specific health screening fields should I include in my blood donor application?: You can add custom fields to track blood type, recent travel history, current medications, and any existing health conditions that would affect donation eligibility.
How can I organize donors by blood type once the forms are submitted?: You can use the software to tag or categorize applicants based on the blood type they entered in the form, making it easier to call specific donors during an emergency.
Can I add a section for donor emergency contacts to the blood donor application?: Yes, the template is fully customizable, allowing you to add a dedicated section for emergency contact names and phone numbers for every donor.
How do volunteers access the form during a community blood drive?: You can set up a tablet as a kiosk at your event or share a QR code that donors can scan to complete the application on their own smartphones.
Can I embed this application directly onto my charity's website?: Yes, you can embed the form on your 'Get Involved' or 'Donate' page so potential donors can apply without leaving your site.
Is it possible to add my organization's branding to the donor form?: You can upload your non-profit's logo and adjust the colors to match your organization's brand identity before sending the form to applicants.

This template is framed for US and provided as a software tool, not legal advice. Waiver enforceability varies by jurisdiction and circumstance — confirm the final wording with your own counsel before relying on it.

Card photo by Joel Muniz on Unsplash