Kidney Transplant - New Patient Information & Forms
New Patient Information & Forms
Please note: This page is only for new kidney transplant patients with a scheduled evaluation appointment.
Required Forms for Initial Appointment
- Online Medical History Questionnaire (Please submit this form online before your appointment)
Please complete and print out the forms and bring them with you to your appointment.
English
- Authorization for Release of Health Information
- Informed Consent To Evaluate
- Notice of Privacy Practices and Acknowledgment of Receipt
- Questions & Answers for Transplant Candidates about Multiple Listing and Waiting Time Transfer
- Terms and Conditions of Service
Español
- Autorización para la divulgación de información de salud
- Consentimiento informado para evaluarnformed
- Aviso de prácticas de privacidad y acuse de recibootice
- Preguntas y respuestas para los candidatos de trasplante sobre el listado múltiple y la transferencia del tiempo de esperau
- Términos y condiciones de servicio
Required Forms of Identification
You must have these at the time of your appointment.
- Photo ID (Required)
- Health Insurance Card (Required)
Pre-Appointment Videos to Watch
Please watch these videos prior to your appointment.
Kidney Transplant Evaluation
- Kidney Transplant Evaluation Presentation (English)
- Presentación de Evaluación de Trasplante de Riñón (Español)
- Kidney Transplant Evaluation Presentation (Cantonese)
Pancreas Alone and Kidney/Pancreas Transplant
- Pancreas Alone and Kidney/Pancreas Transplant (English)
- Solo Páncreas y Trasplante de Riñón/Páncreas (Español)
- Pancreas Alone and Kidney/Pancreas Transplant (Cantonese)
Re-Evaluation Appointment
- Re-Evaluation Appointment (English)
- Nombramiento de Reevaluación (Español)
- Re-Evaluation Appointment (Cantonese)
Living Donor Transplant Program
- Living Donor Transplant Video English | Spanish
- Living Donor Kidney Transplant Video (English)
- Vida Video de riñón de donante (Español)
- We Are Transplant: Stories from the Novartis Transplant Games (Patient Stories)
Patient Education Materials
Please review these prior to your appointment.
- Insurance Information About Your Transplant (English)
- Información sobre el seguro de su trasplante (Español)
- 关于你的移植的保险信息 (中文) (Chinese)
- Introduction: Your Health Matters
- Notice of Privacy Practices Brochure
- Post-Transplant Outcomes Data
- Kidney Allocation
Questions and Other Info
Please call: (415) 353-1551
UCSF Kidney/Pancreas Transplant Team
Connie Frank Transplant Center
University of California, San Francisco
Kidney/Pancreas Transplant Services
400 Parnassus Ave. 7th Floor, Suite 701
San Francisco, CA 94143-0116