Register - BloodConnect

Create your account

Step 1 of 4 - Choose how you want to start. You can add the other role later using the same account.

Choose your starting role *

Recipient I need blood or medical support.

Donor I want to donate blood and help others.

Step 2 of 4 - Personal information

* Required fields

Enter your legal name and birth date.

First Name *

Last Name *

Middle Name (optional)

Date of Birth *

Use contact information you can access.

Email *

Phone No. *

Emergency Contact No. *

Required: enter another person's number we can call in an emergency.

Enter your Bohol municipality and barangay.

Province *

BloodConnect currently serves Bohol.

City / Municipality *

Loading Bohol municipality suggestions...

Barangay *

Suggestions appear after selecting a locality.

Gender *

Blood Type (optional)

You can leave this blank if you do not know your blood type.

Username *

Password *

Confirm Password *

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