Create an Account Fast Track Health History Fast Track Health History Questionnaire I am completing this questionnaire on the day of my donation. I will complete the questionnaire in a confidential setting, free of interruptions. I have read these pre-donation documents and am ready to answer the questions. I will review the Frequently Asked Questions if needed. Your Information Please complete the following required information. To ensure we can accept your Fast Track Ticket, it's important the information you provide below match what we have in our computer system or that it match your legal ID if this is your first time donating with us. First Name Last Name Birth Date Please input date of birth in this order: month/year/date Gender Assigned at Birth Male Female Required fields are indicated with BEGIN QUESTIONNAIRE ×