The Big Ask: The Big Give Becoming a Living Donor Webinar
Sunday, April 26th 1PM - 3PM
This webinar 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 Mayo Clinic Arizona 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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example@example.com
Email Communications Preference
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Yes, I would like to receive email communications from Mayo Clinic.
No, I do not wish to receive email communications at this time from Mayo Clinic.
How did you hear about this workshop?
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Transplant Center communications
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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
Other
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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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