Have you any reason to believe that you may be infected by either Hepatitis, Malaria, HIV/AIDS, and/or venereal disease ?
In the last 6 months have you had any history of the following:-
- Unexplained weight loss
- Repeated Diarrhoea
- Swollen glands
- Continuous low-grade fever
In the last 6 months have you had any :-
- Tattooing
- Ear Piercing
- Dental Extraction
Do you suffer from or have suffered from any of the following diseases?
- Heart Disease
- Lung Disease
- Kidney Disease
- Cancer / Malignant Disease
- Epilepsy
- Diabetes
- Tuberculosis
- Abnormal bleeding tendency
- Hepatitis B / C
- Allergic Disease
- Jaundice (last 1 yr)
- Sexually Trans. diseases
- Malaria (6 months)
- Typhoid (last 1 yr)
- Fainting spells
Are you taking or have taken any of these in the past 72 hours?
- Antibiotics
- Aspirin
- Alcohol
- Steroids
- Vaccinations
- Dog Bite / Rabies vaccine (1 yr)
Is there any history of surgery or blood transfusion in the past 6 months ?
- Major Minor Blood Transfusion
For women donors,
- Are you pregnant
- Have you had an abortion in the last 3 months
- Do you have a child less than one year old?
If answer to any of the above is "yes" then you are not medically eligible to donate blood.
