Community Blood Center Donor Survey

Thank you for being a life-saving donor and welcome to your Community Blood Center Donor Survey.

If you have immediate medical concerns or issues. Please contact us at 1-800-388-4483.
Please tell us about your most recent experience of donating blood - Your compliments and concerns will help us to improve our services.
This brief survey should only take a few minutes to answer.
1) Please enter your Donor ID number. (If you do not know your ID number, enter "00000")
    This number should be located at the top of your Donor Information sheet.
2) Please select the County where you donated blood.
3) Please select the Type of Center where you donated blood.
    Donor Center Blood Drive Inside Blood Drive Bus 
3a) Please let us know the location where you donated blood.
4) Please rate the welcome you received upon arrival.
    Totally Satisfied Satisfied Average Dissatisfied Totally Dissatisfied 
5) How long was your wait to register to donate blood after your arrival time?
    I did not have to wait Less than 5 minutes 5 to 15 minutes 15 to 30 minutes More than 30 minutes 
6) Please rate the insertion of the needle.
    Totally Satisfied Satisfied Average Dissatisfied Totally Dissatisfied 
7) Did staff thank you for giving blood?
    Yes No 
8) Please rate your overall experience.
    Totally Satisfied Satisfied Average Dissatisfied Totally Dissatisfied 
9) Based on this donation experience, can we count on your generosity
       for another blood donation in the future?
    Yes No 
Why will you not donate again?
10) Please make any additional comments about your donation.

Please provide us contact information to help serve you better.

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