The National Blood Service, Medical query form

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Medical query form

If there's anything bothering you about any medical aspect to do with donating blood, then you've come to the right place.
Send us an e-mail and we'll get back to you as soon as possible with the answer. Click here to go to the form below.

Alternatively you can call us on 0845 7 711 711.

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Medical query form

* denotes required field

Title
First Name		*
Surname		*
DOB		*
Post Code

House number		*
Address		*
Town/City		*
County
Email		*
Donor No
Daytime Tel.		*
Evening Tel.
What is your medical query? (please let us know your medical condition, the medication you are taking and if you have received surgery, tell us the dates, so that we can give you a confident answer)		*
Ethnicity

IMPORTANT INFORMATION - PLEASE READ By entering and submitting my details on this form, I hereby consent to the National Blood Service processing my personal data. More info If you do not want to use e-mail to discuss your questions, you may prefer to ring us on 0845 7 711 711, or contact the senior nurse or the duty doctor at your next donation session. Your details will be held securely on our database and handled by our National Contact Centre. Thank You.

Please Tick: *	By entering and submitting my details on this form, I hereby consent to the National Blood Service processing my personal data. More info I hereby consent to the National Blood Service storing and processing the personal information provided by me on the online form above in accordance with its Privacy Policy. In particular, I consent to any medical, religious or other sensitive personal information submitted by me to be used by the National Blood Service to respond to my query or comments. The National Blood Service shall not disclose such information to any other person.

Please Tick:	We will use the information you give us to respond to your query or comments, and to develop and improve the services we provide. We will not disclose it to any third party, other than in accordance with the Data protection Act (1998)

This site uses a secure method of transmitting personal details. More info This site uses a secure method of transmitting personal details which are encrypted by SSLv3 (Secure Socket Layer) ensuring privacy of any submitted information. All information and data that is processed by the NBS is in accordance with the provisions of the Data Protection Act 1998. If you wish to find out more about our commitment to protecting the confidentiality of your data, please ask for the "Data Protection - A guide for donors" leaflet.

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GIVEN BLOOD RECENTLY?

If you have given blood in the last two weeks and have become unwell or had any problems since please do NOT use this form. It is VERY important to us to help you faster - so please call 0845 7 711 711 at any time.