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International School Suva

World Class Citizens ~ Life Long Learners

ISS Community Blood Bank Drive

Dear Parents and Guardians,

International School Suva is having a blood drive. By taking part High School students learn about community service and value of selflessly helping others. In order to donate your child must be at 16-years of age, in good general health. In addition, they must have parental consent. We hope you encourage your child to participate in blood donation. By doing so, your child has the potential to save 3 lives!

Fiji currently uses the whole blood donation which is also the most common. Whole blood donation is where blood is collected from a vein in the arm into a bag that is designed to store blood. Whole blood donations are usually separated into 3 different components: blood, plasma, and platelets.

Precautions are taken to ensure a safe and pleasant donation experience. Donors with no history of medical problems usually have no adverse reactions to donating blood. On occasion, there are donors that experience mild to moderate side effects due to donating blood.  Symptoms include, but are not limited to:

Feeling warm/sweaty, becoming pale, feeling faint or dizzy, upset stomach, bruising, swelling or redness at the needle insertion site, pain at the insertion site, feeling tired and hyperventilation.

On extremely rare occasions, allergic reaction may occur, including hives and/or itching (urticaria), shortness of breath (dyspnea) and nerve damage.

Reactions to blood donation may occur at any time throughout the donation process, including after the donor has left the donation site.

On the day of donation, please make sure your child eats a good meal, is well hydrated and has a good understanding of his/her health history. Your child will be asked a series of questions that are personal in nature and include:

Medications they are currently taking and why they are taking them, history of intravenous drug use. These types of questions are designed to improve the donation experience for your child, and ensure a safe blood product for the recipients of the blood.  It is imperative that these questions be answered honestly to maintain a safe blood supply,

Testing is done on each donation to detect various infectious agents that can be transmitted by transfusion. If there are any abnormal laboratory results, the results will be released to your child and will be shared with you if your child is under 18-years old (by signing the form attached, an 18 year old child consents to this disclosure). However, if your child is 18-years old, results will only be released to the donor. Otherwise, all health history information will be strictly confidential except as required by law.

Your child will be asked to read and sign the following donor consent on the day of donation:

I have read and I understand the “Essential Information” for Whole Blood Donors. All of my questions concerning my donation have been answered to my satisfaction. I understand both the risk and the occasional side effects that can result from donation.

I am fully informed of the laboratory tests which will be performed on my blood. I consent to the performance of the laboratory tests. I am fully informed of the manner in which the results of these tests will be handled. I consent to the disclosure of all such test results to me and to any other party designated by me in writing, which shall include my parents if I am below 18 years of age.

I have truthfully, completely, and accurately answered all the questions on this form. I agree not to donate if am at risk of spreading a virus known to cause other diseases.

I hereby voluntarily consent to donate my blood/blood components to be used as directed by the CWMH Blood Bank.

THE FOLLOWING CONSENT MUST BE COMPLETED AND RETURNED ONLY IF THE STUDENT IS UNDER 18-YEARS OLD ON THE DATE HE/SHE DONATES BLOOD.

The Informational Letter for Parents and High School Blood Donors does not have to be returned with this form.

I CERTIFY THAT I HAVE READ AND FULLY UNDERSTAND THE INFORMATION PROVIDED IN THE INFORMATION LETTER FOR PARENTS AND DONORS, HAVE ASKED AND HAD ANSWERED ANY QUESTIONS I HAVE REGARDING THE DONATIONS OF BLOOD, HAVE THE LEGAL AUTHORITY TO CONSENT TO MY 16 to 18 YEAR OLD SON/DAUGHTER TO DONATE BLOOD TO CWMH BLOOD BANK.

Donor Name (print): ___________________________            Age: _____            D.O.B.: ____          Year level: ______

Name of Parent/Guardian: ___________________________                               Relationship: __________________

Telephone No.: ________________              Mobile: __________          Email: ________________________

Parent/Guardian Signature: ___________________________              Date: ________________________

16 to 18 Year Old Student Signature: _________________________ Date: ________________________