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American Family Children's Hospital
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Living Liver Donor Inquiry

If you would like to talk to someone in the UW Health Transplant Program in Madison, Wisconsin, about the possibility of becoming a living liver donor, we would be happy to contact you. Please complete the form below and someone from the program will contact you shortly.
 

Email is not a highly-secure means of transmitting health information. You may transmit this form via fax or mail if you prefer. By transmitting this completed form you authorize UW Hospitals and Clinics to use this data for purposes related to treatment, research and operations.

 

If you prefer to submit this information by fax or U.S mail, you may print the form after you complete it and send to:

 

Fax

ATTN: Beth Gerndt-Spaith

(608) 262-5420

 

Mail

UW Transplant Program

ATTN: Beth Gerndt-Spaith

600 Highland Avenue, F8/162
Madison, WI 53792-1735