Living Liver Donor Inquiry

Thank you for your interest in living liver donation. Complete the form below to learn more, request information or to be screened as a potential living liver donor. A living liver donation clinical specialist will contact you.


Please note, this form is not a highly secure means of transmitting health information. You may send 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:


ATTN: Living Liver Donor Referrals
(608) 262-5420


UW Transplant Program
ATTN: Living Liver Donor Referrals
600 Highland Avenue, F8/162
Madison, WI 53792-1735