Customer Feedback Form

Thank you for your support of Community Blood Center. Your satisfaction is extremely important to us. We appreciate you taking the time to share your feedback.

Section 1: Customer Information


Please provide a phone number or email address.

*Relationship with CBC



Please include date of occurance, if applicable.


*Response Requested

*Would you like CBC To Contact you?

*If yes, how would you like us to contact you.



Forms on the Community Blood Center (CBC) website are controlled documents and are subject to change by CBC without notice.  CBC is not responsible for errors that may occur if customers use obsolete CBC documents to re-create CBC controlled documents.

CBC.04.F239 version 1.0