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Atlanta Blood Services’ Survey
We value your comments and suggestions!
Please provide us feedback about your recent blood or platelet donation.
Please pick only one answer per question
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Enter your Name  *
Enter your Email-Address  *
1. Please rate your overall satisfaction with your Atlanta Blood Services donation experience
Not satisfied
at all 		Extremely satisfied
1 2 3 4 5
     
2. Please rate the professionalism and skill of the ABS staff that drew your blood and performed the health history screening process
Not satisfied
at all 		Extremely satisfied
1 2 3 4 5
     
3. Please rate your satisfaction with the length of time it took to complete the entire donation experience
Not satisfied
at all 		Extremely satisfied
1 2 3 4 5
     
4. Please rate your satisfaction with the computerized Self Review Questionnaire donor history screen
Not satisfied
at all 		Extremely satisfied
1 2 3 4 5
     
5. Did the atmosphere at ABS provide for an enjoyable experience?
Not satisfied
at all 		Extremely satisfied
1 2 3 4 5
     
6. How likely are you to recommend to your relatives and friends to donate with Atlanta Blood Services?
Not satisfied
at all 		Extremely satisfied
1 2 3 4 5
     
7. How likely are you to donate again with Atlanta Blood Services?
Not satisfied
at all 		Extremely satisfied
1 2 3 4 5
     
8. Why do you give blood? (please choose only one)
 
I was asked by a friend/family/co-worker
I come in regularly to donate
Someone I know needs or did need blood
I heard about the donor incentives
I was recruited by Atlanta Blood Services
     
9. Was this your first time donating any type of blood product?
Yes No
     
10. Do you donate with blood collection agencies other than Atlanta Blood Services?
Yes No
     
11. Where do you most prefer to donate?  
 
Work
School
A community center (church, social groups)
Atlanta Blood Services
Hospital or other medical facility
     
12. What time of day do you most prefer to donate?  
 
Morning
Afternoon
Evening
     
13. Did you receive a reminder call before your donation appointment?
Yes No
     
 
   
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