Get Kidney Donation Form

This guide provides step-by-step instructions for users on how to complete the Kidney Donation Form online. Our aim is to support you in this important process by providing clear and concise information for each section of the form.

Follow the steps to fill out the Kidney Donation Form online with ease.

1. Click ‘Get Form’ button to obtain the form and open it in your editor of choice.
2. In the Donor Details section, fill in your surname, first name, and middle name. Indicate your sex by selecting the appropriate box (Male = 1, Female = 2). Provide your date of birth, ensuring you are aged 70 years or younger. If you are an altruistic donor, note that you can omit sections 4 and 5.
3. For the Donor Suitability Assessment, enter your height in centimeters, weight in kilograms, and calculate your BMI. Record your blood pressure and indicate any history of hypertension, including the number of medications if applicable. Specify your blood group.
4. Complete the health history section by indicating your glycaemic status, history of renal stone disease, malignancy, and any screenings conducted if you are over 50 years old. Provide dates where applicable.
5. Address the virology assessment by indicating the results for various tests (CMV, EBV, HIV, etc.), specifying positive or negative results along with the test dates.
6. In the kidney function and anatomy section, provide your serum creatinine levels, urine protein/creatinine ratio, and details around kidney size and anatomy as instructed.
7. In Section 3, indicate your donor status on the AKX List by selecting from the options provided (active, suspended, or removed). If applicable, give a reason for suspension or removal.
8. Section 4 asks for recipient details. Fill in the recipient's surname, first name, and sex. Include their date of birth and NOMS Recipient ID if applicable.
9. For Section 5, provide information on the relationship of the donor to the recipient, and indicate if the potential donor is blood group incompatible or if there are HLA antibody incompatibilities.
10. In Section 6, confirm donor consent and provide the date it was signed. This consent must be witnessed by a nephrologist or transplant coordinator.
11. Complete Section 7 by entering your full name, signature, position, and contact details. Lastly, fill in the date.
12. Once all sections are filled out, review the information for accuracy. You can then save changes, download, print, or share the completed form as needed.

Complete your Kidney Donation Form online today to assist those in need.