Donor to Donor Non-Directed Donor Survey
Donor to Donor is a foundation devoted to creating awareness of the kidney crisis in this country, to help patients in need of a kidney to find a donor, and to help people interested in becoming a living donor to do so as effectively as possible. Our website is www.donortodonor.com and our FB page is https://www.facebook.com/DonorToDonor/ .

We are in the process of compiling a directory of Non-Directed Donors (NDD’s). We will never disclose the names of the participants without the prior approval of the individual. A short questionnaire is attached which will provide the information for the database. This directory has multiple purposes:

1) We expect that a fairly complete directory of NDD’s in this country will be of interest to researchers. The questions are designed to provide a minimal amount of information in this regard, with further participation in a given research project by each NDD on an opt-in basis.

2) NDD’s are a unique sub-category of organ donors. It is our desire to see that hospitals conduct their transplant center practices with the best interest of the donors in the forefront. NDD’s have a unique perspective on some of these matters and we believe that a collective action by this group, on an opt-in basis, may help ensure those best practices.

3) At any one time, there are a number of state and federal legislative initiatives pending. We would like to be able to add the weight of the NDD community to the organizations which are leading this effort in the various legislatures.

Donor to Donor's website is https://www.donortodonor.com and our Facebook page is https://www.facebook.com/DonorToDonor. Please contact nedbrooks@donortodonor.com for further information.

Email address *
1. First Name *
Your answer
2. Last Name *
Your answer
3. Date of Birth *
MM
/
DD
/
YYYY
4. Female/Male *
Required
5. Marital Status
6. Donation Surgery Date *
MM
/
DD
/
YYYY
7. Age at Time of Donation *
Your answer
8. Transplant Center *
Your answer
9. Approximate time between initial contact with transplant center and surgery
Your answer
10. Did you have any difficulty with the lab work associated with your testing? *
11. If "Yes", please describe:
Your answer
12. Which kidney did you donate? *
13. How many separate incisions did you receive?
Your answer
14. Days in Hospital Post-operation *
Your answer
15. Recovery period until resuming work or otherwise feeling mostly "normal" *
Your answer
16. Please describe the nature of your employment *
17. For how many days post-op did you take pain medication? *
Your answer
18. Number of Recipients in your chain, if known
Your answer
19. Did you follow up at the hospital for health checks at: *
2 weeks
6 months
1 year
2 year
Row 1
20. If you missed any of those check-up dates, did the hospital reach out to you to come in? *
Required
21. Please approximate the total expenses you incurred as a result of your donation, including travel expenses, lost wages and other expenses
Your answer
22. Did you have medical complications as a result of your donation? *
23. If "Yes", please describe
Your answer
24. Did you have any subsequent complications, physical or emotional, as a result of your donation? If yes, please describe.
Your answer
25. Why did you decide to donate your kidney? *
Your answer
26. If you had the choice, would you donate again? *
27. If "Yes", why?
Your answer
28. If "No", why not?
Your answer
29. Has your insurance coverage been impacted in any way as a result of your donation? If so, please describe. *
Your answer
30. Have you been in contact with your recipient? *
31. Please add any additional comments you would like us to know about
Your answer
A copy of your responses will be emailed to the address you provided.
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