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Date/Start Time of Blood Drive: 
January 23, 2009 08:00 AM
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Your Name: 
Test chairperson |
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Title: 
Blood Drive Chairperson |
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Organization Name: 
Test Organization name |
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Your Phone Number: 
123465 Phone : Ext. |
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E-mail: 
tester@test.com |
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Projected # of donations: 
50 |
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Actual # of collected donations: 
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Name of Donor Services' Charge Person: 
Charge Person |
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Your Community Relations Representative (CRR): 
CRR |
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1) |
Were you able to observe the Blood Drive in progress?
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Yes No, but I visited the Drive location No, I did not visit the Drive location |
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2) |
Did your CRR Communicate on a regular basis, prior to your Blood Drive?
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Yes No, it was not necessary No, I would have liked more communication Don't Know |
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3) |
Please rate the professionalism and customer service of your CRR.
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Excellent Very good Good Fair Poor Don't Know |
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4) |
Did your CRR assist in booking the blood drive date and time well in advance?
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Yes, appropriate time was given No, not an option No, more time was needed. Don't Know |
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Please provide comments:
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5) |
Was eDonor utilized to schedule appointments in advance?
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Yes No, eDonor is not suitable for us. No, please provide me more information about eDonor Don't Know |
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6) |
Did your CRR help you set realistic goals?
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Yes No, it was not necessary No, I would have liked more communication Don't Know |
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7) |
Did your CRR help you choose a suitable place for the blood drive?
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Yes No, it was not necessary No, I would have liked help Don't Know |
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8) |
Did your CRR offer a group presentation?
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Yes No, it was not necessary No, I would have liked a group presentation Don't Know |
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9) |
If a group presentation was given, please rate it
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Excellent Very good Good Fair Poor No presentation given
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10) |
Did your CRR provide you with enough recruitment materials?
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Yes No, they were not necessary. No, more were needed. Don't Know |
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11) |
Were the recruitment materials of good quality?
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Yes No Don't Know |
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12) |
Were the recruitment materials delivered on time?
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Yes No, they were not necessary. No, should have been earlier Don't Know |
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13) |
Did the staff in charge of the mobile drive introduce themselves?
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Yes No, not practical No Don't Know |
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14) |
Did your donor services' blood collection STAFF wear name tags?
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Yes No, not practical No Don't Know |
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15) |
Did the blood drive begin on time?(January 23, 2009 08:00 AM)
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Yes No, but no fault of FBS No Don’t Know |
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16) |
How would you rate the professionalism and customer service of the FBS Team servicing your Blood Drive?
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A)
The blood collection staff's personal appearance?
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Excellent Very good Good Fair Poor Don't Know |
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B)
The technical ability of the blood collection staff?
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Excellent Very good Good Fair Poor Don't Know |
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C)
The blood collection staff's rapport with the blood donors?
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Excellent Very good Good Fair Poor Don't Know |
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D)
Overall, how would you rate Florida Blood Services' performance at your blood drive?
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Excellent Very good Good Fair Poor Don't Know |
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17) |
On average, how long did the donation process take? (from donor sign-in to post-donation refreshments)
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Less than 39 mins 40-49 minutes 50-59 minutes 60-75 minutes More than 75 mins Don't Know |
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18) |
Was the time donors spent at the blood drive acceptable to your organization?
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Yes No, but no fault of FBS No Don't Know |
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19) |
Is there anything special or new that you or your group did to improve the success of this blood drive? If yes, describe:
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20) |
Do you believe Florida Blood Services appreciates your group for sponsoring a blood drive?
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Yes No Don't Know |
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21) |
Would you like to discuss your blood drive with a member of our management team?
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Yes  No |
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Please provide the topics you would like to discuss.
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22) |
Is there anything more your FBS team can do to help you with your blood drive?
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Yes  No |
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Please explain:
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23) |
If you know of any other groups who might be willing to sponsor a blood drive, please list them here:
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Receive a valuable gift card if you refer an organization that sponsors a Blood Drive with 20 or more donors. |
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24) |
Please place additional comments in the space provided:
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