Tell Us Your Story | ImpactLife

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share your story

All fields marked with * are required.

Name *

Address *

City *

State *

Zip Code

My first blood donation... When and where? New or long-time donor?

I became a blood donor because...

I usually give blood at... mobile blood drive (where) or donor center (which site)?

My most frequent donation procedure is... whole blood, apheresis or double red cell.

When I give blood, I think about...

I invite others to give blood because...

I hereby grant permission for ImpactLife to use my name and the information I have submitted in Donor Recruitment materials, including profiles on the company website, in advertising and on printed flyers and brochures. If so, please initial and date the form below.

Initial *

Date *

Share Your Story

share your story