Agomoni Blood Donation 2022 – Interest Form October 8, 2022 958Views Please enable JavaScript in your browser to complete this form.Agomoni is organising a Blood Donation camp on 12th Nov 2022, at San Ramon Regional Medical Center. We appeal you to volunteer in donating blood and make this initiative a success! Please fill in this form if you are interested. (It will take less than a minute! ) [Note: CDC follows the FDA guidelines on accepting/deferring donors who have resided or travelled to any Malaria-endemic countries. Unfortunately, most part of India fall into the malaria-transmission risk area, as per CDC. Herein, we are collecting some travel related information, so that you will be better informed about the eligibility before you register with our blood drive partner Vitalant. https://www.youtube.com/watch?v=spPcFqHrrW0 ] (Please fill in the same form separately for any other adult family members, who might be interested in donation too.)Email *Your Full Name *Phone *Are you a prior resident of India? (i.e. lived in India for more than 5 consecutive years ever) *YesNoHave you ever stayed in the USA for 3 consecutive years or more, without traveling to India or or other Malaria-endemic countries? *YesNoCDC approved other Malaria-endemic countries Have you been in India or any malaria-risk countries anytime after Aug 12th 2022 or likely to travel before Nov 12th 2022? *YesNoWe will reach out to you soon with more details to register with our drive partner Vitalant. Thank you! for your time to provide the information Submit
