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Please review and answer these questions to help ensure the safety of the community blood supply and help your donation process be more efficient. If you answer yes to any of these questions on the day you
present to donate, you will not be eligible to donate at that time.
1. Do you weigh less than 110 pounds or more than 350 pounds? 3. Are you ill or not feeling well today? 4. Are you taking antibiotics today for an active infection? 5. Have you taken Accutane, Proscar or Propecia in the last month? 6. Have you taken Coumadin/warfarin in the last 7 days? 7. Have you received a tattoo or a piercing that was not performed in a 8. Have you ever been diagnosed with lymphoma and/or leukemia? 9. Are you currently receiving treatment for a diagnosis of cancer? a. If yes, is the treatment for cancer other than - basal cell,
squamous cell skin cancer or carcinoma in situ (any size)? 10. In the past 12 months, have you traveled outside the U.S. or Canada? a. If yes, did you travel to any of the countries or cities listed on the table? This table includes common malarial areas, but is not an
all-inclusive list. If you have travel questions, please contact
Bonfils’ Donor Relations department.

Sao Tome & Principe Islands
Ciudad Obregon
Copper Canyon

Sierra Leone
El Fuerte
Los Mochis
Any area outside
Nuevo Vallarta
Benin (Dahomey)
San Pedro Sula or Tegucigalpa
Burkina Faso
(including the Bay Islands)
Punta de Mita
Punta Mitla
Salina Cruz
Central African Republic
Comoros Islands

Any area outside
Cote d’Ivorie (Ivory Coast)
Rangoon or Mandalay
Democratic Republic of Congo

Any area outside Managua
Equatorial Guinea
Any area outside
Bogota or Cartegena
Costa Rica
Ivory Coast
Any area outside Manila
Dominican Republic
If you have any questions you may contact Bonfils’ Donor
Relations department at 303.363.2202 in the Denver Metro
area or 800.365.0006, option 1 outside of the Denver
Metro area or ask a Bonfils staff member at the drive.
These questions are used for pre-screening purposes only. Even if you answered no to all of these questions at the time of pre-screening, you may be ineligible to donate based on the answers given during the questionnaire and interview process completed just prior to the actual donation.


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