The Blood Center
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Request for Further Information

Posted by Paul Adams on June 2, 2020 7:54 AM


Request for Further Information

Thank you for your support of The Blood Center and the volunteer blood donor program. At this time, our records indicate you are ineligible as a volunteer blood donor. If you would like more information, please complete this form and return to a staff member or submit below. 

Name: Donor ID#:
Address: Apt.#
City: State: Zip:
E-Mail:
Day Phone: Evening Phone:
Date of Birth: SS# (Last 4-digits):

 

 

 

Or Print & Mail to:
Medical/Legal Department
The Blood Center
2609 Canal St.
New Orleans, LA 70119