Signature of the donor, on the donor questionnaire, countersigned by the health care staff member responsible for obtaining the health history confirming that the donor has:

1. (a)

   read and understood the educational materials provided;

2. (b)

   had an opportunity to ask questions;

3. (c)

   been provided with satisfactory responses to any questions asked;

4. (d)

   given informed consent to proceed with the donation process;

5. (e)

   been informed, in the case of autologous donations, that the donated blood and blood components may not be sufficient for the intended transfusion requirements; and

6. (f)

   acknowledged that all the information provided by the donor is true to the best of his/her knowledge.