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| 1. |
When you first donated blood, how old were you? |
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| 2. |
How many times have you donated blood in the past 5 years? |
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| 3. |
Has anyone close to you ever received a blood transfusion? |
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| 4. |
Have you ever received a blood transfusion? |
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| 5. |
Have you ever encouraged someone to give blood? |
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Continue to Page 2 |
