Send a Care Card to a Donor Family

Select the Care Card* you would like to send to your donor’s family below. This card will be sent to our Aftercare Services team for review. From there, an Aftercare Specialist will forward the card to your donor family.

You may wish to include your full name and other direct contact information in your card or remain anonymous. The form below is intended for Aftercare Services to match you to the correct family. This information will not be forwarded to your donor family.

*The copy shown in the example Care Cards below is only sample text. Your Care Card will include your personal message.

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Send a Care Card to a Donor Family

Personal

*First Name: *Last Name: *DOB: *Organ/Tissue Received: For tissue recipients only: Please include your tissue ID # obtained from your surgeon *Date of Transplant:

Month Month January February March April May June July August September October November December Day Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month Year 20242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966

*Transplant Hospital: *Your Text:

Contact

*Email Address: *Phone Number: *Address Line1: Address Line2: *City: *Zipcode: *State: - Select your state - Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Federated States Of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia WisconsinWyoming Check any items below that you permit; your identity will remain confidential at all times.: I authorize and consent to the reproduction and publication of my letter: (Any portion or its entirety) to be shared with New England Donor Services (NEDS) staff. (Any portion or its entirety) to be shared with the public for the purpose of educational and marketing. I would be interested in sharing my donation story; please contact me. Note for Staff:

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