Donor Screening

Please fill in the following form to have your pet screened as a blood donor. More information about eligibility requirements can be found on our Blood Donation page. If your pet meets all requirements, you will be contacted by our team.

First Name*

Last Name*

Email*

example@example.com

Phone Number*

Format: (000) 000-0000.

Your pet's name*

Species*

dogcat

Breed*

Age*

Does your cat weigh at least 4.5 kg (10lbs)?*

YesNo

Does your dog weigh at least 22.7 kg (50lbs)?*

YesNo

Is your cat indoor only?*

YesNo

Is your pet neutered?*

YesNo

What is the name of your regular vet clinic?*

Can we contact your vet for your pet's medical records?*

YesNo

Has your pet ever traveled outside of the country/BC? If yes where and how long ago?*

Has your pet had a blood transfusion in the past?*

YesNo

Is your pet up to date on all vaccines and receiving regular flea/tick/heartworm/deworming preventative medications (if applicable to species)?*

YesNo

If no, are you willing to visit your regular vet to update your pet’s vaccines?

YesNo

Please list all medications/supplements and frequency of which your pet receives at any time? (ex. occasional Metacam)?*

who, when, where, how, what

Has your pet been fed a raw diet?*

YesNo

Which brand(s) of pet food and treats do you use?*

Has your pet received treatment for a long-term chronic condition?*

YesNo

Does your pet have an agreeable temperament that allows for administration of mild sedation?*

YesNo

Would you consent to a small shaved area on the neck and gentle sedation for blood donation?*

YesNo

What is your Monday to Friday availability?*

OPTIONAL: How did you discover our blood donation program?

who, when, where, how, what