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
  • A Confidential Unit Exclusion Label
  • 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

Respecting your privacy: about the Confidential Unit Exclusion Label

Because of the personal nature of the questions in the Record of Donation questionnaire, sometimes donors are uncomfortable to answer them truthfully, or to provide certain pieces of information. They may not want to tell friends, family or colleagues that they have been deferred—and so continue with the donation to avoid answering uncomfortable questions.

To give people the opportunity to protect their privacy and at the same time safeguard the blood supply, we give all donors a pair of bar-coded labels called Confidential Unit Exclusion Labels. One indicates that the donor’s blood can be used and the other asks that the blood not be used. Once the appropriate label has been placed on the Record of Donation, no one at the clinic can determine which was chosen. It is only later, in the laboratory when a technician scans the label with a barcode reader, which indicates whether or not the unit is to be used.