Please complete and submit the form below to refer a patient for kidney/pancreas transplant evaluation. Upon receiving the information and records below, we will verify evaluation eligibility and send you a letter outlining our decision. If eligible, we will contact the patient to discuss details about the process and to begin scheduling the evaluation.
When the evaluation has been completed, we will inform you of the results of your patient’s testing and our recommendations regarding their suitability for kidney/pancreas transplant.
Should you have any questions throughout this process or thereafter, please do not hesitate to contact our office at 314.362.5365.
You can also download the Kidney/Pancreas Transplant Referral Form if you prefer to fax or mail your patient referral.