{% extends 'base.html' %} {% load static %} {% block title %}Donor Eligibility Check - {{ donor.full_name }}{% endblock %} {% block css %} {% endblock %} {% block content %}

Donor Eligibility Check {{ donor.full_name }} ({{ donor.donor_id }})

Donor Information

{{ donor.full_name }}

{{ donor.donor_id }}

Blood Group: {{ donor.blood_group.display_name }}
Age: {{ donor.age }} years
Weight: {{ donor.weight }} kg
Total Donations: {{ donor.total_donations }}
Last Donation: {% if donor.last_donation_date %} {{ donor.last_donation_date|date:"M d, Y" }} {% else %} Never {% endif %}

{% if is_eligible %} Eligible for Donation {% else %} Not Eligible for Donation {% endif %}

{% if is_eligible %} This donor meets the basic eligibility criteria. {% else %} Next eligible date: {{ next_eligible_date|date:"M d, Y" }} {% endif %}

Eligibility Screening Questionnaire

Required before donation
{% csrf_token %}
Basic Health Questions
{{ form.feeling_well }}
{% if form.feeling_well.errors %}
{{ form.feeling_well.errors.0 }}
{% endif %}
{{ form.adequate_sleep }}
{% if form.adequate_sleep.errors %}
{{ form.adequate_sleep.errors.0 }}
{% endif %}
{{ form.eaten_today }}
{% if form.eaten_today.errors %}
{{ form.eaten_today.errors.0 }}
{% endif %}
Medical History
{{ form.recent_illness }}
Including cold, flu, fever, or any infection
{{ form.medications }}
Including prescription and over-the-counter medications
{{ form.recent_travel }}
Travel to malaria-endemic areas may require deferral
Risk Factors
{{ form.recent_tattoo }}
Including permanent makeup and body piercing
{{ form.recent_surgery }}
Any surgical procedure or dental work
Additional Information
{{ form.notes }} {% if form.notes.errors %}
{{ form.notes.errors.0 }}
{% endif %}
Back to Donor
{% endblock %} {% block js %} {% endblock %}