National Living Donor Assistance Center > How to Apply

Paper Application Process - Step by Step Guide

NLDAC can cover the cost of travel, lost wages, and dependent care for eligible living donors on their evaluation, surgery, and follow-up trips to the transplant center. Eligibility is based on the recipient’s yearly household income. A completed donor application worksheet and recipient application worksheet are required, except for non-directed donors who have not chosen a recipient. Please see the videos at the bottom of this page for complete information about eligibility and the application process. If you have questions or need assistance, please call 888-870-5002.

There are three steps to the application process. To apply, the donor and recipient must:

Complete and sign a NLDAC Application Worksheet and Attestation Form.

Worksheet Type	English	Spanish
Complete Donor/Recipient Application Worksheet
Donor portion of Application Worksheet
Recipient portion of Application Worksheet
IRS Form W-9 (only for donors who request wage or dependent care reimbursement)

Attach a copy of one or more of the following documents to verify household income:

Federal income tax return
Pay stubs
W2
Social Security award letter
Other documents

If the recipient’s household income is greater than 350% of the Federal Poverty Guidelines, the recipient must complete and submit a financial hardship waiver worksheet.

Worksheet Type	English	Spanish
Recipient Financial Hardship Waiver Worksheet

Give these documents to your transplant coordinator, social worker or other transplant professional.

The transplant professional will file the NLDAC application the donor’s behalf. Do not send completed worksheets to NLDAC. We do not accept applications from patients.

NLDAC cannot reimburse expenses that have already occurred. We recommend completed applications be submitted as early as 6-8 weeks before travel or surgical procedure.

Applications	Deadline
Preference Category 1, 2, and 3	No later than 10 business days before travel or surgery
Preference Category 4	No later than 15 business days before travel or surgery

All applications must be approved and funded before surgery.

Learn what you need to know before applying for NLDAC assistance by reading our Program Snapshot.