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Organ and Tissue Donation Donor Tributes

To share your story, complete the form below and select the submit button. Once it's received, your story will be posted in our Donor Tributes section.

 

You may submit a photo using the form below, or printed photos may be mailed to the OPO (address below). We will scan the photo and post it with your memorial.

 

Please include the first and last name of your loved one so we may match it with the correct tribute.

 
e-Mail Address:
 
First Name (optional):
 
Last Name (optional):
 
Your Phone (optional):
 
Address:
 
City:
 
State and ZIP Code:
 
Donor Name:
 
Your Story:

 

 

Authorization to Use Image/Information On Web Site

 

Select the check box below to grant permission:

 

 By submitting my personal story of care received at UW Health, I authorize UW Health to use my information and/or pictures for use on www.uwhealth.org. I understand I can have this information removed from www.uwhealth.org at any time by contacting ehealth@uwhealth.org.

 

 
 

Mailing Address (for photos or tributes)

 
Kathy Schultz
Senior Marketing Consultant
UW Health Transplant/OTD
301 S. Westfield Road, Suite 250
Madison, WI 53717