Living-donor appointment request
Complete the form below to start the process of becoming a living kidney donor at Mayo Clinic Florida.
Only people living in the United States should use this form. If you live elsewhere and are interested in becoming a living donor, please email us including your full name, date of birth (MM-DD-YYYY), telephone number, city, country, time zone and preferred language if not English. A scheduler will call you, with an interpreter if appropriate, to register you as a potential living donor.
All fields are required unless marked optional.
There is a problem with information submitted for this request. Review/update the information highlighted below and resubmit the form.
Your request for an appointment is very important. However, there was a technical error. Please contact us by phone at 904-956-3249 to continue registering as a potential living kidney donor.
Living-donor appointment request
Thank you for registering and watching the informational video. The next step is to complete the Donor History Questionnaire form (https://mayofl.donorscreen.org/register/now). The questionnaire will take approximately 15-20 minutes to complete. In case you cannot complete this form at this time, an email will also be sent to allow you to complete the form later.
No additional action can occur with your request until the Donor Health History Questionnaire has been completed and received by Mayo Clinic Florida.