Blood Donor Full-Length Donor History Questionnaire (DHQ)

Form Template

Blood Banks can use the app to have blood, plasma and platelet donors complete a detailed health questionnaire.

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The app covers how the donor is feeling the day of donation as well as 48 hours before, 8 weeks, 16 weeks, 12 months, three years and previous years. The Blood Donor Full-Length Donor History Questionnaire (DHQ) mobile app allows you to replace your paper history questionnaire with a mobile device like a smartphone or tablet. The mobile questionnaire includes fields to document items such as date, blood bank, address, donor name, and health questionnaire. Once the mobile app is filled out a secure PDF is generated. The PDF is easy to share, and a copy is stored in your account for your blood bank records. You can also use the App Builder to personalize and customize this mobile form. This app can be made HIPAA compliant to protect the privacy of your blood donor's medical information.

Features
  • Submission Editing
  • Reference Data
  • Dispatch
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Platforms
  • iPhone
  • iPad
  • Android
  • Windows
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Integrations
  • Quickbooks
  • Salesforce
  • Google Docs
  • Dropbox
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*The Capterra SoftwareAdvice ​and GetApp logos are a service mark of Gartner, Inc. and/or its affiliates and is used herein with permission.*

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