Potential Donors

Application Process:

Thank you for your interest in applying to the National Living Donor Assistance Center. To file an application for donor travel expense to the transplant center, the recipient and the donor must complete NLDAC Application Worksheets and Attestation forms. Both completed worksheets must be given to your transplant center professional who will file an application on behalf of the donor. Eligibility is based on yearly household incomes. You must also provide documentation of your yearly household income with your application worksheet. Examples of accepted documents are: pay stubs, W-2, Federal income tax return, Social Security statement, HUD, WIC, Medicaid or other document. Do not send completed worksheets to NLDAC. NLDAC cannot accept applications from patients. If you need assistance, call 703-414-1600 or toll free at 888-870-5002. We are happy to help.

Application Worksheets

Donor Application Worksheet and Attestation Form
Click here for English Click here for Spanish (Bilingual)

Recipient Application Worksheet and Attestation Form
Click here for English Click here for Spanish (Bilingual)

NLDAC cannot reimburse expenses that have already occurred. We recommend complete applications with Preference Category 1, 2 and 3 be submitted as early as 6-8 weeks, but no later than 10 business days before the surgical procedure or travel. Complete applications with Preference Category 4 may also be submitted as early as 6-8 weeks, but no later than 15 business days before the surgical procedure or travel. Please call NLDAC at 703-414-1600 or toll free at 888-870-5002 if you have questions or need more information.

If the recipient or donor household income is greater than 300% of the HHS Poverty Guidelines, you may request a waiver for financial hardship. Please complete the Financial Hardship Waiver Worksheet and give to your transplant professional.

Click here for English Click here for Spanish

Step by Step Diagram of Application and Donation Process

NLDAC Q & A
  1. NLDAC Overview
  2. NLDAC Eligibility
  3. NLDAC Preference Categories
  4. NLDAC Allowances
  5. NLDAC Limits
  6. NLDAC Authorizations and Regulations
  7. Other Sources of Financial Support
 

Potential Donors

If you are considering organ donation, NLDAC may be able to lessen the burden of travel expenses. View the NLDAC Eligibility Screening Tool for NLDAC household income requirements. To learn more about the application process, read the NLDAC brochure "How to Apply" in English or Spanish.

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Transplant
Centers

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