Get Ucla Form 500575 2011-2026

Filling out the UCLA Form 500575, the living kidney donor intake form, is an important step in the donor process. This guide provides clear instructions to help users navigate the online form with ease and confidence.

Follow the steps to complete the form accurately and efficiently.

1. Press the ‘Get Form’ button to obtain the form and launch it in the online editor.
2. Enter your personal information in the designated sections, including your name, date of intake, and contact details such as email and phone numbers.
3. Provide your demographic information, including age, date of birth, marital status, race, and citizenship status.
4. Indicate your primary language and specify if you speak English by selecting 'Yes' or 'No'.
5. If applicable, fill in information regarding your maiden name and your mother’s maiden name.
6. Detail your educational background and current employment information, including employer name and job title.
7. Complete the section about the recipient, providing their name and date of birth.
8. Fill out the medical history section, addressing any medications, allergies, or health issues for yourself or your family.
9. Answer questions regarding previous medical check-ups and discuss your donation intention with your family or significant other.
10. Finally, review all information for accuracy, and once confirmed, save your changes, download, print, or share the completed form as needed.

Take the next step in your donation process by completing the UCLA Form 500575 online today.