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Get OSU Wexner Medical Center Living Donor Assessment Form 2019

T S STATUS: TRANSFUSION HISTORY: Please complete all sections and submit this form along with a copy of your blood type to the Pre-Transplant Office at the Ohio State Comprehensive Transplant Center. INFORMATION ABOUT YOUR RECIPIENT Recipient s name to whom you wish to direct your organ donation: Recipient s Date of Birth: Your relationship to the Recipient: How did you learn of the Recipient s need for an organ transplant? Have you met the Recipient? Yes No Is your Recipient a p.

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