Kidney Transplant Referral
You can be referred to the Iowa Methodist Transplant Center for an evaluation by your nephrologists, dialysis unit or a self-referral.
To begin the referral process, please answer the following questions and complete the Kidney Transplant Recipient Referral form below. In addition, please complete the Authorization for Release of Health Information, Dental Clearance form and Informed Consent for Kidney Transplant Recipient form and either fax or mail the forms back to the Transplant Center. These forms must be completed and sent back to the Transplant Center before an evaluation will be scheduled.
Iowa Methodist Transplant Center
1215 Pleasant Street, Suite 506
Des Moines, IA 50309
Authorization for Release of Health Information
Dental Clearance Form
Dental Clearance Form (Spanish)
Informed Consent for Kidney Transplant Recipient
Informed Consent for Kidney Transplant Recipient (Spanish)
Kidney Transplant Recipient Referral Form
If Durable Power of Attorney for Health Care, Bring to Evaluation