Write To Your Donor Family
Your Name
*
First Name
Last Name
Name of Recipient (if different)
First Name
Last Name
Contact Email Address
*
example@example.com
Contact Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Transplant
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Transplant Hospital
*
Transplant Received
*
Kidney
Liver
Heart
Cornea
Pancreas
Lung
Intestine
Tissue
If we have any questions, how do you prefer we contact you? Please make sure you provide us with this method of contact.
*
Email
Phone
Transplant Center
United States Mail
Your Message
*
Please upload up to 5 photos you would like us to share with your donor family.
Browse Files
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Permission to Share My Letter*
At times, Gift of Life may share letters from recipients with our community partners for awareness and education related to organ and tissue donation. It can be very meaningful for individuals who do not know a transplant recipient to hear the words of gratitude. Please indicate if you authorize Gift of Life Donor Program, its affiliated organizations, and community partners to reprint or share the contents of your letter as described. Personal identifying information such as full names will not be shared.
I grant Gift of Life Donor Program permission to reprint or share the contents of my letter for awareness and education related to organ and tissue donation.
I do not grant Gift of Life Donor Program permission to reprint or share the contents of my letter for any purpose other than providing to my family member’s recipients.
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