Thank you for your desire to participate in this program!

The American Red Cross/Vitalant/OneBlood/ABC/Local Source will determine when convalescent plasma is available and deliver it as soon as possible. This may be a longer wait than typical blood products.

Link to IRB Protocol: Protocol

Link to Consent Forms: English, Spanish, Arabic

Instructions:

Please fill in the details below and hit “submit” in order to enroll your patient in the program.

You must complete this form before you can receive convalescent plasma.

You must retain a copy of the patient code as it must match with the plasma product your patient is about to receive and is needed for your activities in the program.

Information, protocol, consent forms and site registration, enrollment and followup forms are available at www.USCOVIDplasma.org.

If you have any questions or difficulties registering please email USCOVIDplasma@mayo.edu, which will be monitored from 7am-7pm CST.

Note: Submission of this form on iOS devices using Safari may cause duplicate submissions. If possible, please submit from another browser such as Google Chrome, Internet Explorer, or Mozilla Firefox. Thank you.

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