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International Accreditation of Healthcare Facilities

Standards › Standard 5 › Forms

Form · BLD-FRM-001 · Version 1.0 · Approved by the ASF Expert Committee

Supports: 5.1

Purpose

Records the screening of each donor and any deferral.

How to complete

Checks

Check Entry
Questionnaire completed Yes
Examination completed and recorded Yes
Eligible to donate Yes or deferred
Deferral reason and return date Yes or N/A
Screened by and date Yes

Evidence

Reference Note
E-009 Donor criteria to follow the national blood service guidance.
E-006 ASF Policy Framework v1.2. Adapted.
E-009 ASF Expert Committee consensus.

Change history

Version Date What changed Approval
1.0 the date of approval First version set Expert Committee approval

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