City of Irvine Civic Center and CicloIrvine Event APPOINTMENT REQUEST FORM

UCI Health and the City of Irvine Civic Center/CicloIrvine Event are partnering for a life-saving blood drive on Saturday, May 4, 2024 from 11am to 4pm. The UCI Health Blood Mobile will be located on the corner of Harvard and Barranca in Irvine.

This blood drive will help to increase the supply for patients at UCI Health, Orange County’s only Level I Trauma Center during this extremely challenging time to collect blood.

All donors will receive their choice of a $5 gift card or T-shirt. 

 In addition, we recommend reading the basic donation requirements prior to making your appointment. You can find them here: http://www.ucihealth.org/medical-services/blood-donations

Please note that for safety reasons, we are unable to allow children on the bloodmobile. Please do not bring young children who cannot wait outside the bloodmobile unsupervised for 30 minutes or more.

Due to COVID-19, extra precautions will be taken for your safety as well as the safety of our staff. Please read the important COVID-19 information below and do not make an appointment if any apply to you.

              You have or recently experienced any of the following symptoms: fever, chills, muscle aches, cough, shortness of breath, unexpected fatigue, sore throat, loss of taste or smell, headache, diarrhea, vomiting or nausea.

              You have been diagnosed with or suspected of having COVID-19 in the past 14 days.

              You have lived with someone who has been diagnosed with or suspected of having COVID-19 in the past 14 days.

If you have recently received the COVID-19 vaccine from Pfizer, Moderna or Novavax, there is no deferral unless you are currently experiencing side effects. If you were a part of a study and received an experimental COVID-19 vaccine other than Pfizer, Moderna or Novavax, you must wait 1 year before donating blood.

Please complete and submit this online donor form. Appointments are currently available for the time selections shown.

Thank you for volunteering to donate and we look forward to seeing you at the CicloIrvine Event.

Fields with * are required.
 

Verify Eligibility

Fields with * are required.
Eligibility is determined based on age. If user is a minor it then determines eligibility based on gender, height and weight.
 
Gender:*
 
Date of Birth:*
Format: (mm/dd/yyyy) and must be 17 at time of donation.