"Give the ultimate gift of life" Dr. Elizabeth Pomfret, Chief of Transplantation
Welcome to UCHealth's online health history questionnaire for living donation. Our first priority is to protect the health
and well-being of potential donors. This questionnaire is CONFIDENTIAL. Only healthcare professionals from the UCHealth Living Donor
Team will see your information. Your information is NOT shared with the transplant recipient or others.
Please answer all questions honestly and correctly as the information provided here will be used by our living donor team to look
carefully at your medical history to make sure donation will be a safe option for you.
This survey will take approximately 15-20 minutes to complete. You must complete the survey in a single session, and we recommend
you use a desktop or laptop computer for best results.
Please choose below whether you wish to be evaluated for living donor kidney or liver.