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Download relevant forms for donation

Here you will find access to relevant forms to help ensure a seamless experience.

Parent consent for minors
Privacy Practice
Deferred donor reinstatement

*Please note that due to the high volume of Deferred Donor Reinstatement requests, it could take 3-4 months before we are able to review and respond to your reinstatement request. Thank you for your patience. 

Parent Consent

Donating blood is an easy way for younger blood donors to show school pride and significantly help the communities in which they live. Becoming a volunteer blood donor at an early age helps establish a lifelong commitment to community service and saving lives.

PARENTS/GUARDIANS: Be sure to read the following information before printing and signing the consent form giving your minor donor permission to donate blood.

Students who are interested in blood donation must:

  • Be at least 16 years old and have parental or guardian consent
    • 17-year-old donors do not need parental or guardian consent unless they live in these states (or their school requires it): Arizona, Colorado, Montana, Utah, Washington or Wyoming
  • Weigh at least 110 pounds
    • Specific height/weight criteria may apply for donors 22 years old or younger. For requirements in your area, please call 877-258-4825.
  • Be in good general health
  • Bring a consent form signed by a parent or guardian to your appointment

Learn more about blood donation eligibility or call us at 877-25-VITAL (877-258-4825). Thank you for supporting our lifesaving mission!


Notice of Privacy Practice

This information is relevant for individuals receiving Vitalant’s HIPAA covered healthcare services.

Notice of Privacy Practice (Spanish Version)

 

Reinstatement Form

Thank you for your interest in donating blood and helping to save lives! Please complete the following reinstatement form* if you were:

  1. Previously deferred from giving blood by Vitalant (or one of our legacy blood centers),
    or
  2. Told by Vitalant you were ineligible due to a deferral that was applied to your donor record.

*You will be contacted via email or mail once your reinstatement has been completed. Due to the high volume of reinstatement requests, it could take up to 8 weeks before we are able to review and respond to your reinstatement request. Thank you for your patience.

Note: If you have never donated with Vitalant (or one of our legacy blood centers), please check our current donor eligibility information. Please do not complete the form below if you have not donated with Vitalant or one of our legacy blood centers.

You will be contacted via email or mail once your reinstatement has been completed.

Note: * indicates a required field

 

To complete the form please check the box below