Join as an apheresis donor (red blood cells, plasma and platelets)

Identification

• Yes
  What is your donor number?

  What is your blood type? Select A- A+ B- B+ AB- AB+ O- O+ I don't know
• No

*Where did you fill out this form?

• On the Héma-Québec Web site
• At a blood drive
  *In which city/town (e.g., Montréal)? *At which location (e.g., McGill University)?

*Who asked you to fill out this form?

• Volunteer
• Héma-Québec staff member
• Ambassador donor:
• Other (friend, family member, co-worker, etc.), please specify:

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