Record of Donation

What is My Record of Donation?

The Record of Donation (PDF) is a form that captures all the relevant information about you and your donation. It goes with you from registration to screening to donation, and the confidential questionnaire helps us decide if you are eligible to give blood.

What’s included in your Record of Donation

  • Your name, address, and date of birth
  • Your blood type once it has been confirmed through a successful donation
  • Results of physical tests including hemoglobin, blood pressure and temperature
  • The names of the Canadian Blood Services staff who served you
  • Your answers to questions on health and high-risk activities
  • Any comments from the screening employee
  • Deferral codes, if applicable
  • Relevant details about your donation (venepuncture and bleed time)
  • Unit labelling information
  • Your signature, confirming your informed consent to use the blood collected and that you have answered all questions truthfully