The Big Ask: The Big Give Becoming a Living Donor Workshop
Saturday, May 30th 9AM - 12PM Culinary Dropout Grant Tucson 2543 E. Grant Rd. Tucson, AZ 85716
This workshop will explore what being a living donor is all about, including how to connect with a transplant center and what to expect throughout the donor evaluation process.
This program is held in partnership with Banner University Medical Center - Tucson and the National Kidney Foundation of Arizona.
Attendee Information
Please complete this form for each person who will be attending.
Name
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First Name
Last Name
Email Address
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Email Communications Preference
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Yes, I would like to receive email communications from Banner - Tucson.
No, I do not wish to receive email communications from Banner - Tucson.
How did you hear about this workshop?
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Transplant Center communications
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Home Zip Code
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Street Address
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What is your connection to kidney disease?
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I am a kidney patient
I am a friend/family member of a kidney patient
I am a healthcare professional
I am a living donor
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If you are a kidney patient, what is your type of connection to kidney disease?
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I have CKD Stage 1 or 2
I have CKD Stage 3
I have CKD Stage 4 or 5 and am not on dialysis
I am on dialysis
I am a transplant recipient
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Are you currently a patient at an Arizona Transplant Center?
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No
Yes, Banner University Medicine Transplant Center, Tucson
Yes, Banner University Medicine Transplant Center, Phoenix
Yes, Mayo Clinic Transplant Center
Yes, St. Joseph's Hospital & Medical Center, Phoenix
Yes, Phoenix Children's Hospital
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What is the highest grade or year of school you completed?
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