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pdfBDMS Health History Questions
Blood Donor Management System (BDMS)
Sustainment and Maintenance Services
Contract# NNG07DA45B
Order Number W81XWH-11-F-0086
December 06, 2013
Defense Health Clinical Systems (DHCS)
Mr. Chester Alexander
Product Line Manager
Contracting Officer’s Representative
[email protected]
Planned Systems International, Inc.
10632 Little Patuxent Parkway, Suite 200
Columbia, MD 21044-6250
410.964.8000
BDMS Health History Questions
Revision History
Version
Date
Author/Editor
Comment
1.0
06 December,
2013
Team PSI
Initial Version
December 2013
i
BDMS Health History Questions
Table of Contents
Section 1 -
Introduction .................................................................................................... 3
Allogeneic Questions ............................................................................................................. 4
Autologous Questions.......................................................................................................... 53
Therapeutic Questions ......................................................................................................... 68
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BDMS Health History Questions
Section 1 -
Introduction
The following document provides screenshots of all Donor Health History Questionnaire
questions in the Blood Donor Management System (BDMS). The questions are based on the
current version of the UDHQ, and consist of separate question sets for Allogeneic, Autologous,
and Therapeutic donations. Each question set contains a required competency assessment, in
addition to all questions required for that donation type. All sex-specific questions are noted as
such above the related screenshot.
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BDMS Health History Questions
Allogeneic Questions
COMPETENCY
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BDMS Health History Questions
1.
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BDMS Health History Questions
2.
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3.
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BDMS Health History Questions
4.
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5.
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BDMS Health History Questions
6.
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BDMS Health History Questions
7. (FEMALE DONORS ONLY)
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BDMS Health History Questions
8.
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BDMS Health History Questions
9.
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10.
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11.
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12.
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13.
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14.
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15.
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16.
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17.
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18.
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19.
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20.
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BDMS Health History Questions
21. (FEMALE DONORS ONLY)
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22.
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23.
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24.
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25.
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26.
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27.
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28.
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29.
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30.
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31.
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32.
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33.
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34. (MALE DONORS ONLY)
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35.
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36.
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37.
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38.
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39.
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40.
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41.
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42.
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43.
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44.
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45.
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46.
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47.
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48.
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BDMS Health History Questions
Autologous Questions
COMPETENCY
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BDMS Health History Questions
1. (FEMALE DONORS ONLY)
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2.
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3.
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4.
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5.
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6.
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7.
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8.
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9.
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10.
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11.
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12.
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13.
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14.
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BDMS Health History Questions
Therapeutic Questions
COMPETENCY
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1. (FEMALE DONORS ONLY)
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2.
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3.
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4.
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5.
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6.
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| File Type | application/pdf |
| File Title | BMBB/TS Instructor's Guide |
| Author | Team Thundercat |
| File Modified | 2014-04-19 |
| File Created | 2014-04-19 |