Kidney Transplant Referral
The Transplant Center receives referrals for kidney transplant evaluations from nephrologists, self-referrals and dialysis units.
To request an appointment or to make a referral, please complete the required forms below and either fax or mail the forms back to the Iowa Methodist Transplant Center. These forms must be completed and sent back to the Transplant Center before scheduling an evaluation.
Iowa Methodist Transplant Center
1215 Pleasant Street, Suite 506
Des Moines, IA 50309
Authorization for Release of Health Information
Health History Questionnaire
Doctor Contact Form
Dental Clearance Form
Dental Clearance Form (Spanish)
Informed Consent for Kidney Transplant Recipient
Informed Consent for Kidney Transplant Recipient (Spanish)