Living Donor Application | Iowa Methodist Transplant Center

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Living Donor Form | Iowa Methodist Transplant Center

Living Kidney Donor

Thank you for your interest in becoming a living kidney donor at the Iowa Methodist Transplant Center. Please answer the following questions and complete the Living Donor Health History Questionnaire. We will call you after receiving and reviewing your application. Please call us at (515) 241-4044 if you have any questions. 


Sex
Best time to contact *
I am interested in becoming a humanitarian donor *
Do you have someone in mind for your donation? *
Do you smoke?
Do you have problems with blood sugar/diabetes?
Did you have blood sugar problems/diabetes during pregnancy?
Are you currently being treated for High Blood Pressure?
Do you take blood pressure medication?
Were you treated for High Blood Pressure during pregnancy?
Do you have heart problems?
Do you have a history of kidney stones/problems?
Do you have a history of urine/kidney infections?
Have you ever had cancer?
Do you have any religious beliefs that would prohibit you from accepting blood if needed?