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 complete the required forms below 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
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)