Thank you for your interest in becoming a milk donor to the Perron Rotary Express Milk Bank (PREM Bank). To ensure donated milk is safe, we ask all donors questions relating to health and lifestyle, similar to blood donor screening. Please be accurate and honest. If you do not register or complete the assessment, no information is stored. If you do register, your information remains strictly confidential. This is a preliminary screening only.


Have you ever:

Do you currently:

In the last twelve months have you:

Do you currently have: