Complete Your Health History Questionnaire Online

It takes about 10 minutes to answer the yes/no health history questions. Taking the health history questionnaire online may save you about 20 minutes at the blood drive or blood center collection site.

Important Note:  Please read the following documents prior to beginning the online Health History questionnaire.

  • Instructions to Complete Online Health History Questionnaire
  • Zika – Research Participant Information Sheet
  • Frequently Asked Questions

Please be sure to complete the questionnaire in a private setting which assures confidentiality.

The questionnaire must be completed on the same day as your donation.