Team Iowa Profile

By filling out and submitting this form, you agree to have your personal information shared with Team Iowa members, Iowa Donor Network, Iowa Lions Eye Bank and/or the Transplant Games of America including but not limited to print materials and social media. If you do not wish to have your information shared you can choose to leave certain responses blank or forfeit completing this form entirely.

Select Team Iowa Profile Type:

Recipient

First Name *

Last Name *

Email Address *

Age

Male

Female

City

State

Family Background

Share a brief story about your need for a transplant.

Transplant Date

Organ(s) Received

How has your life changed since receiving your gift?

Have you had any communications with your donor family and/or living donor and if so, is there anything you'd like to share about him/her?

How do you support organ donation awareness?

What areas of competition do you plan on participating in for the upcoming 2021 Transplant Games?

Have you participated in the Transplant Games before?

When and where?

What advice would you give to new participants?

Please ZIP and attach up to 5 high res images as .jpg or .png. (250Mb Limit)
(Images can also be emailed to teamiowatransplant@gmail.com)

Living Donor Form

First Name *

Last Name *

Email Address *

Age

Male

Female

City

State

Family Background

Donation Date

Organ(s) Donated

What information can you share about your recipient?

What made you choose to become a living donor?

How has your life been affected since becoming a living donor?

How do you support organ donation?

What areas of competition do you plan on participating in the 2021 Transplant Games?

Have you participated in the Transplant Games Before?

When and where?

What advice would you give to new participants?

Please ZIP and attach up to 5 high res images as .jpg or .png. (250Mb Limit)
(Images can also be emailed to teamiowatransplant@gmail.com)

Your Information

First Name *

Last Name *

Email Address *

City

State

Relationship to Donor

Male

Female

Donor's Immediate Family Members

Add Another Family Member

Donor Information

Donor's First Name *

Donor's Last Name *

Date of Death

Age at Donation

Male

Female

Please share the gifts your loved one so graciously donated along with any recipient information you wish to share.

Donor Bio

Please ZIP and attach up to 5 high res images as .jpg or .png. (250Mb Limit)
(Images can also be emailed to teamiowatransplant@gmail.com)

Team Iowa Profile

Recipient

Living Donor Form

Your Information

Donor Information

Supporter

Our Vision:

Understanding Donation

Donor Families

Professional Partners

Transplant Recipients

Team Iowa Profile

Recipient

Living Donor Form

Your Information

Donor Information

Supporter

Our Vision: