The registration form is admittedly lengthy, but breaking the form down into sections will help show why it asks for each type of information. There are also several absolutely-must-have fields on the form that must be completed for processing, and we’ll highlight those here.
Click on the image of each form to see a larger version. Required items are highlighted in yellow.
Must-have fields
- Full name
- Full address -- street, city, state, zip
- Telephone number (Home # can be a cell phone #)
- Email address
The first information used to contact you if you are indeed discovered to be a match.
Must-have fields
- Are you Hispanic and/or Latino?
- Specified ethnic origin
Due to the significant need for minority donors,
the specification of the donor’s ethnic origin is extremely important.
Must-have fields
- These fields are considered optional.
The employer and spouse information (if applicable) are recorded solely to contact you if you are a match.
Must-have fields
- Full name
- Telephone number
- Email address
Be The Match requests that you provide the contact information for two people who do not live with you. People move, change phone numbers, and change email addresses, and as a result your own contact information may not be enough to reach you when you’re found to be a match. Those who live with you are more likely to move with you than those who do not.
Many people hesitate to include the contact information of others for fear of their contacts being solicited. Be The Match understands that this is a valid concern and as a result takes privacy very seriously. Because it’s so hard to recruit donors in the first place, BTM wants to make absolutely sure that they do nothing to break the trust between the organization, its patients and its donors.
A very common mistake is that duplicate addresses or phone numbers are added in this section. Please make sure that the two contacts you provide do not cohabitate.
Medical Questionnaire
Must-have fields
- Height and weight
- All yes/no answers
- Additional details for any answers marked "yes", or other medical conditions not included on the form
To assure the safety of both the donor and the patient, Be The Match requires the completion of a brief medical questionnaire which is composed of yes/no questions. If any of the questions are answered “yes” BTM provides a lined area for further comments. Also, if donors have a medical condition or take medication that they think may exclude them from the registry, BTM asks that they share that information in the lines provided.
Agreement and signature
Must-have fields
- Printed name
- Signature
- Date of signature
The last step of the registration form is to read and understand the donor agreement. This section outlines the donor’s rights and responsibilities and must be completed to register the cheek sample.
A missing signature on the back page of the registration form is the number one error on all registration forms, and will block your ability to be registered.
After the form is completed, donors move onto the cheek swabs!
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