Giving Life a Second Chance
Through Organ & Tissue Donation

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Request a Speaker

Please fill out the form below to request a speaker to discuss organ and tissue donation.

Thanks for your support!

* Required Fields
First Name*
First Name*
Last Name*
Last Name*
Organization Name*
Email Address*
Retype Email Address*
Street Address*
Street Address*
City*
City*
State*
State*
Zip Code*
Zip Code*
Email Address*
Retype Email Address*
What organ did you receive?*
HeartLung
KidneyPancreas
LiverIntestine
CorneaTissue
Describe the event for which you'd like a speaker?*

Words left: 300

Name of hospital where you received your transplant*
Date Event is Taking Place (DD/MM/YYYY)
Date of Transplant*
Time of Event
Please type your message to the family of your donor.*
Daytime Phone Number*
What is your preferred method of contact from Gift of Life Donor Program?*
E-mailRegular Mail

iconRegister to Be a Donor

It’s easy to add the donor designation to your driver's license or state I.D. card. In Pennsylvania, New Jersey and Delaware. Sign up today!

 

Resources for Families

Image of Family House Logo

Lodging and Support

Thousands of patients come to Philadelphia hospitals every year needing life-saving organ transplants. Family House will provide critically needed support programs and temporary lodging for organ transplant patients and their families.

 
 
 
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