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PHLEBOTOMY
POST TRAINING SKILLS EVALUATION

Name of Phlebotomist: ______________________________________________________

Designation: _______________________________________________________________
Name of Facility: ____________________________________________________________
Contact No. _____________________________Email Address: _______________________

Name of Donor Date of Mobile Certified by: (BMC-BBTS)

Blood Donation
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I hereby certify that the above information is true and correct and I have fulfilled ten (10) successful
venipunctures during actual Mobile Blood Donations in compliance to the completion to the Course:
Training on Phlebotomy for the National Voluntary Blood Services Program.

Submitted by:
___________________________
Date: ______________________

use this link: https://bit.ly/NDPCONFE2023

or email us at: nvbsp@bicol.doh.gov.ph