Intranet.amitx.com

BLOOD DONOR GUIDELINES
If you have any questions, please ask a member of our staff
General Donor Requirements

• All donors must provide a personal photo identification
• Medications: Not currently taking antibiotics or other medication for an active infection • Eating: Eat within four hours before donating
Permanent Travel Disqualifications
FROM 1980 THROUGH 1996
If you spent time that adds up (cumulative) to 3 MONTHS OR MORE in the
United Kingdom (U.K.)
(England, Northern Ireland, Scotland, Wales, the Isle of Man, the Channel
Islands, Gibraltar or the Falkland Islands)
FROM 1980 TO THE PRESENT
If you spent time that adds up (cumulative) to 5 YEARS OR MORE IN
EUROPE
(including time spent in the U.K. from 1980 through 1996)
Albania, Andorra, Austria, Belgium, Bosnia-Herzegovina, Bulgaria, Croatia, the
Czech Republic, Denmark, Finland, France, Germany, Greece, Holy See,
Hungary, Ireland, Italy, Liechtenstein, Luxembourg, Macedonia, Monaco, the
Netherlands, Norway, Poland, Portugal, Romania, the Slovak Republic, San
Marino, Slovenia, Spain, Sweden, Switzerland, the U.K., and Yugoslavia
(Serbia, Kosovo, Montenegro)
FROM 1980 THROUGH 1996
If you were a member of the U.S. military, a civilian military employee, or a dependant of a member of the U.S. military and you were associated with a military base in any of the following countries: a. For 6 MONTHS OR MORE FROM 1980 - 1990
Germany, United Kingdom, Belgium or the Netherlands
b. For 6 MONTHS OR MORE FROM 1980 - 1996
Greece, Italy, Portugal, Spain or Turkey
Permanent Disqualifications

History of cancer (except basal cell carcinoma of the skin or
carcinoma in-situ of the cervix)
BLOOD DONOR GUIDELINES
If you have any questions, please ask a member of our staff
Temporary Disqualifications
y: OK to donate six weeks after end of pregnancy • Tattoos / Ear or Body Piercing: OK to donate if performed more than 2 weeks ago in a state-licensed facility
o Travel to malaria-risk areas: ask staff for specific countries o Been in jail or prison for more that 72 consecutive hours o Had a blood transfusion o Had sexual contact with a person with HIV/AIDS or a positive test for HIV/AIDS Medication Deferral List

Accutane (isotretinoin, Amnesteem, Claravis, Sotret) – usually given for severe acne
Avodart (dutasteride) – usually given for prostate gland enlargement
Coumadin(Warfarin) - usually given to prevent clots
Growth Hormone from Human Pituitary Glands – used only until 1985, usually for children with delayed or
Hepatitis B Immune Globulin – given following an exposure to hepatitis B. NOTE: This is different from the
hepatitis B vaccine which is a series of 3 injections given over a 6 month period to prevent future infection from exposure to hepatitis B. • Insulin from Cows (Bovine, or Beef, Insulin) – used to treat diabetes
Plavix (Clopidogrel) – usually given to prevent stroke or heart attack
Proscar (finasteride) – usually given for prostate enlargement
Propecia (finasteride) – usually given for male pattern baldness
Soriatane (acitretin) – usually given for severe psoriasis
Tegison (etretinate) – usually given for severe psoriasis
Unlicensed Vaccine – usually associated with a research protocol
Symptoms Associated with HIV/AIDS
• Unexplained weight loss of more than 10 pounds within past 2 months • Unexplained sweating, especially at night • Fever higher than 99oF for more than a week • Swollen glands or enlarged lymph nodes in neck, armpit or groin – with or without pain • Pink, blue or purple spots or lumps, raised or flat, on or under skin or in the mouth, nose, ears (look like bruises, but don’t disappear) White patches in the mouth (thrush) • Persistent cough and shortness of breath Testing of Blood Products

• To protect patients, your blood is tested for infectious diseases and certain other viruses. If your blood tests
positive it will not be transfused to a patient. • If you have any reactive or abnormal test results you will be notified by mail and your information will be placed in our electronic deferral database. You will not be able to donate again. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA)
NOTICE OF PRIVACY PRACTICES
OUR PLEDGE REGARDING HEALTH INFORMATION:
We understand that your health information is personal. We are committed to protecting your health information, otherwise referred to as Protected Health Information (PHI). We create a record of the medical history information and all testing of your blood donations. We need this record to comply with certain legal requirements. This notice applies to all of the records of your donations generated by this health care facility. This notice will tell you about the ways in which we may use and disclose health information about you. We also describe your rights to your health information, and describe certain obligations we have regarding the use and disclosure of your PHI. We are required by law to: • Make sure that health information that identifies you is kept private • Give you this notice of our legal duties and privacy practice with respect to PHI • Follow the terms of the notice that is currently in effect

Source: http://intranet.amitx.com/intranet/library/jpg/misc/blood-donor-guidelines.pdf

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PINEHURST MEDICAL CLINIC ENDOSCOPY CENTER PHONE: 910-235-3177 Appointment Date: ___________________ Arrival Time: ___________ Location: _____________________ Physician: ________________ Special Medication Instructions If you take any blood thinners such as Coumadin, Plavix, Effient, or Pradaxa and you did not see one of our GI providers in clinic, please contact our office

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Table 3. County vouchers needed at WTU herbarium, arranged alphabetically by county Adams County (42 taxa) Adonis aestivalis Monitor Aegilops cylindrica C Cardaria draba C Carduus nutans B Cenchrus longispinus B Centaurea solstitialis B Centaurea diffusa B Centaurea calcitrapa A Centaurea stoebe B Centaurea repens B Chondrilla juncea B Cirsium arvense C Cirsium vulgare C Conium

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