VersiPASS Online Questionnaire
Use VersiPASS to answer your donor questionnaire from the comfort of your home, the day of your appointment.
VersiPASS is a one-stop shop for donors across Versiti’s footprint to review reading materials and complete their health history questionnaire privately, prior to arriving for their donation. We look forward to taking care of you at your blood donation appointment later today.
VersiPASS must be completed the same day of your donation.
Please bring your printed or mobile confirmation to your appointment. Without it, you will be required to complete another questionnaire onsite.
If you are under 17 years of age, please review, complete and print out the parental consent form below.
Valid only on date identified on completion confirmation. Successful completion of VersiPASS does not guarantee eligibility to donate; verification of eligibility will be determined on location at time of donation.
For additional eligibility questions, please review common eligibility and blood donation process FAQ's or call 877-232-4376.
By clicking the button below and launching the application you are confirming you are in a private setting to complete your questionnaire.
Do you live in Dayton, Ohio? Please answer your donor questionnaire online intake form here.