Campus Blood Center Appointment Request Form

Thank you for your interest in donating at our donor center on the UC Irvine campus. We truly appreciate your support. The UCI Medical Center transfuses over 1000 units of blood to our patients each month. That means we need at least 1000 people to donate each and every month.

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

IMPORTANT COVID-19 INFORMATION: Please note that if you have had any of the following symptoms in the last 14 days you will not be able to donate- Fever, chills, muscle aches, cough, shortness of breath, unexpected fatigue, sore throat, loss of taste or smell, headache, diarrhea, vomiting or nausea

Please read the following deferrals related to COVID-19 before making an appointment.  

1) if you are living with someone or had exposure to someone with Covid, you must wait 14 days and be totally symptom free during that time.

2) If you had Covid, you need to be symptom free for 14 days prior to donating

 3) if you received the Pfizer, Moderna or J & J Covid vaccines, there is no deferral. If you received any other COVID vaccines or were part of a study which required you to receive another Covid vaccine, you must wait 1 year to donate or until that vaccine has received approval in the U.S.                                                                     

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 UCI Campus Blood Donor Center. If you have any questions or would prefer to make your appointment over the phone, please contact us at 949-824-2662 or at ibleedblue@uci.edu




 
Fields with * are required.
 
 
CURRENT HOURS
 
Day   Open
Monday    9:30 AM to 5:00 PM
Tuesday    9:30:00 AM to 5 PM
Wednesday    12:00 PM to 7:00 PM
Thursday    9:30 AM to 5:00 PM
Friday    CLOSED
Saturday    CLOSED
Sunday    CLOSED

 
 
YOUR INFORMATION  - PLEASE ENTER YOUR LEGAL NAME
 
First Name:*
 
Nick Name:
 
Middle Name / Middle Initial:
 
Last Name:*
 
Date of Birth:*
/ / Format: (mm/dd/yyyy)     
 
Suffix:
 
Gender:*
 
Email:*
 
Confirm Email:*
 
Preferred Phone:*
 
Phone:*
 
Need a parking pass:
*If you require a parking permit, please provide your license plate number and state or VIN ( if no license plates). If you do not currently have access to this information, please take a photo of your license plate or VIN once you park and bring it to the donor center.
 
APPOINTMENT INFORMATION
I understand that I have the option of a free COVID-19 antibody test when I donate blood or platelets. The antibody test DOES NOT diagnose a current COVID-19 infection. It may determine if you were previously infected with the virus.
 
I have had one or more of the following symptoms in the last 14 days: fever, chills, muscle aches, cough, shortness of breath, unexpected fatigue, sore throat, loss of taste or smell, headache, diarrhea, vomiting or nausea
 
I have been exposed to someone who tested positive for COVID-19 or is suspected to have COVID-19 in the past 14 days.
 
Blood Type:
 
Appointment Type:*
 
Appointment Date:*
Format: (mm/dd/yyyy)
 
Appointment Time:*
You must first enter an appointment type and date to select a time.
 
What made you schedule an appointment today?: