Blood Donation Appointment Request
Inova Blood Donor Services supplies blood to patients at
15
hospitals in the Washington DC metropolitan area. Over 200 donors are needed
everyday to help many sick and injured patients including cancer patients, newborns
with complications and patients who have lost blood as a result of injury, surgery
or organ transplantation. A single trauma patient can use over 30-40 units of
blood in just one hour.
First Name
Last Name
Birth Date (mm/dd/yy)
-
-
Please be sure to include your phone number so that we can call and
confirm your appointment.
Work Phone (area code)
Home Phone (area code)
E-mail
Blood Donor Center
or
Blood Drive (community
blood drives)
(please specify drive)
Blood Type
(Automated Blood Collection
is available at Woodburn Donor Center, Centremed Donor
Center, Inova Blood Donor Center at Dulles Town Center, or Inova
Alexandria Hospital.)
Appointment Date (mm/dd/yy)
-
-
Appointment Time
(donor center
hours or community
blood drives)
(HH:mm am/pm)
Comments
Please Note: We will call you to confirm your appointment. Please do not consider
your request confirmed until you receive a phone call.
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Be a Hero.
Give Blood.
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Blood
Donor Center Locations
Eligibility
Requirements
If you would like an appointment within the next two days, please do
not complete this form. Instead, call 1-866-Blood Saves
(866-256-6372) to schedule your appointment. |
