Application Process - Step by Step Guide

NLDAC provides financial support for living donors to travel 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 for every application. 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
Complete and sign a NLDAC Application Worksheet and Attestation Form.
Worksheet Type English Spanish
Complete Donor/Recipient Application Worksheet Combined Application Worksheet -English Combined Application Worksheet -English Combined Application Worksheet -Spanish Combined Application Worksheet -Spanish
Donor portion of Application Worksheet Donor portion of Application Worksheet -English Donor portion of Application Worksheet -English Donor portion of Application Worksheet -Spanish Donor portion of Application Worksheet -Spanish
Recipient portion of Application Worksheet Recipient portion of Application Worksheet - English Recipient portion of Application Worksheet - English Recipient portion of Application Worksheet - Spanish Recipient portion of Application Worksheet - Spanish

Attach
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 300% 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 Recipient Financial Hardship Waiver Worksheet -English Recipient Financial Hardship Waiver Worksheet -English Recipient Financial Hardship Waiver Worksheet -Spanish Recipient Financial Hardship Waiver Worksheet -Spanish

Give
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.

Patient Testimonials
Learn what you need to know before applying for NLDAC assistance by reading our Program Snapshot
Organ Donor
University of Arizona
ASTS
Arbor Research Collaborative for Health
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