Hoxworth Blood Center Donor Survey

Thank you for being a life-saving donor and welcome to your Hoxworth Donor Survey. If you have immediate medical concerns or issues. Please contact us at 513-558-1304. Please tell us about your most recent experience of donating blood - Your compliments and concerns will help us to improve our services.

This brief survey should only take a few minutes to answer. To begin, have your DONOR INFORMATION Form available and locate your 8 digit Unit ID Number on it.
1) Locate your Unit ID Number Barcode on the right side of your DONOR INFORMATION Form.
    Enter the 8 numbers shown after W0377.


    
 
2) Please select the Location where you donated blood.
Donor Center  Blood Drive Inside  Blood Drive Bus  
 
3) Please select the County where you donated blood.

    
 
4) Please select the Center where you donated blood.

    
    
 
5) How many times have you donated in the last 12 months?

     First Time  One to Two times a year  Three to Four times a year  More  
 
6) Did we make you feel valued and appreciated ?
     Yes  No  
 
7) Please rate the welcome you received upon arrival.
     Totally Satisfied  Satisfied  Average  Dissatisfied  Totally Dissatisfied  
 
8) Please rate the total time you felt you were unnecessarily waiting during the entire donation process.
     I did not have to wait unnecessarily  Less than 5 min  5 to 15 min  15 to 30 min  Over 30 min  
 
9) Please rate the friendliness of our staff.
     Totally Satisfied  Satisfied  Average  Dissatisfied  Totally Dissatisfied  
 
10) Please rate the professionalism of our staff.
     Totally Satisfied  Satisfied  Average  Dissatisfied  Totally Dissatisfied  
 
11) Please rate your overall experience.
     Totally Satisfied  Satisfied  Average  Dissatisfied  Totally Dissatisfied  
 
12) How did you find out about our patient needs and the donation location you visited?
     Previously donated or called by center  Radio  Internet or e-mail  Postcard or mailing  Other  
 
13) Based on this donation experience, can we count on your generosity
       for another blood donation in the future?
     Yes  No  
    Why will you not donate again?
    
 
14) Please rate the insertion of the needle.
     Totally Satisfied  Satisfied  Average  Dissatisfied  Totally Dissatisfied  
 
15) If you made an appointment , was your appointment time honored?
     Yes  No  Did not make an appointment  
 
16) Please rate the ease of making your appointment
     Totally Satisfied  Satisfied  Average  Dissatisfied  Totally Dissatisfied  
 
17) Was the donor center or blood drive as clean as it should be?
     Yes, definitely  Yes, somewhat  No  
 
18) Did you feel that the blood collection staff was skilled and competent?
     Yes, definitely  Yes, somewhat  No  
 
19) Did the blood collection staff talk in front of you as if you weren't there?
     No  Yes, sometimes  Yes, often  
 
20) Did staff thank you for giving blood?
     Yes  No  
 
21) Please make any additional comments about your donation.

    
 
Name   (Optional)
Email Address 
Address   (Optional)
City   (Optional)
State   (Optional)
Zip   (Optional)
Phone   (Optional)

 
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