LifeBridge Health > Plasma Donation

Plasma Donation

LifeBridge Health is looking into whether antibodies in blood from those who have recovered from COVID-19 may be beneficial as potential treatment for some people who currently have the disease.
 
As part of this, LifeBridge Health is looking for those who have recovered from COVID-19 for a volunteer donation of blood plasma (also known as a convalescent plasma donation). 
 
LifeBridge Health is partnering with the American Red Cross to coordinate these plasma donations, as well as following the FDA-approved protocol for plasma donation and treatment.
 
Those who may be interested should fill out this web form, and someone from our team will contact you.

Your information will only be used by LifeBridge Health, consistent with HIPPA regulations and the LifeBridge Notice of Privacy Practices.



* Indicates required information

* First Name:



* Last Name:



* Email Address:



* Phone Number:




*City:



* State:



* Zip Code:



* Date of Birth: (mm/dd/yyyy)



* Blood Type:




 Gender



 If female, are you pregnant?



 If female, how many pregnancies have you had?



* What date did symptoms begin?:



*Have you tested positive for COVID-19?




If so, date of COVID test: (mm/dd/yyyy)



Which hospital/facility completed your COVID Test?:



Please check any symptoms that you had originally.


* When did you last experience COVID symptoms?: (mm/dd/yyyy)



* Do you still have symptoms




* Did a doctor tell you that you probably had COVID-19 but did not test you




* Were you symptomatic while living with a COVID-19 positive person?




* Were you symptomatic after direct contact with COVID-19 patients as a healthcare worker?




 If you have already registred with an out-of-town COVID plasma registry, please let us know which one



* Have you had a repeat COVID test?




 If so when: (mm/dd/yyyy)



 What were the results?



 Have you done antibody testing?



 If yes, what were the results?



* Are you a current patient of LifeBridge Health or one of it’s practices or hospitals.




* Have you ever donated to The American Red Cross?




* Authentication:

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