Blood Drive Coordinator
Confidentiality Agreement

We value and protect the confidential nature of information pertaining to our blood donors and employees, and, therefore, request that you agree to the following:

I understand it is my responsibility as a blood drive coordinator for United Blood Services to ensure that all such confidential information is handled privately and with the utmost discretion. Therefore, I agree to use such confidential information only to promote blood drives and recruit blood donors, and I will not disclose any such confidential information to any other person, firm, or corporation, nor use it for my personal or professional benefit, or any other purpose, during or after my volunteering. 

I further agree that it is my responsibility to inform any blood drive volunteers about the expectation of confidentiality related to donor or United Blood Services information. I also understand that disclosure of any confidential information that I may receive, overhear, or have access to as a result of my role as blood drive coordinator may result in irreparable harm to the reputation or operations of United Blood Services or to the individuals whose confidential information is disclosed. 

I further agree that I will promptly return or securely destroy any and all confidential information immediately upon the request of United Blood Services. If I become aware of any confidential information being disclosed (even inadvertently) I will inform a blood center representative immediately. 

I acknowledge my obligation to maintaining the privacy of any confidential information, and understand this agreement shall remain in effect while I serve as a blood drive coordinator for United Blood Services and even after I no longer serve in that role.


If you run drives for more than one organization please list them all.

Organization 1:*
City 1:*
Organization 2:
City 2:
Organization 3:
City 3:
My UBS Representative*