Whole Blood Donor Questionnaire (Lebanon)

Form Template

The questions in the app are important for donor’s safety and the safety of the patient receiving the blood transfusion.

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Please have donors read and stress the importance of answering honestly and accurately each one of the medical history questions. The app can be made secure due to the sensitive nature of the questions. All answers should be kept confidential. The Whole Blood Donor Questionnaire (Lebanon) mobile app allows you to replace your paper blood donor questionnaire with a tablet or smartphone. The mobile form includes fields to document items such as name, date of birth, sex, donation type, and donor number. 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.

Features
  • Signature Capture
  • 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.*

Don't take our word for it...

“I’m not a tech guy and I was able to pick this thing up in probably an hour, and actually start to build apps. I’ve done them over lunch when I’ve gotten frustrated with a process that didn’t exist in our company. So for non tech people who’ve got a problem, the support here is awesome and I’d recommend it to anybody, not just in our industry.”

Dave Kramer, PennLine Service

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