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Oxford University Hospitals NHS Foundation Trust

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Transplant list form

This form can be used by patients on the Oxford transplant list to:

  • Inform us of a holiday (this form is not suitable for use if your holiday is within 2 weeks, in this case please contact your transplant coordinator).
  • Change your contact details (should your current details need to be changed urgently - i.e. mobile contract is cancelled, moved house etc - please contact you transplant coordinator directly to update these details immediately).
  • Order more monthly blood test bottles from the transplant immunology department.

The information you submit via this form is secure. However, unless you specifically ask us not to, we will contact you by email to acknowledge this form has been received and confirm what has been done as a result; these emails will include some of the personal information that you give us in this form. Please note that emails are not a secure method of communication and may be intercepted. If you are concerned about your personal information being sent in this way, please telephone your transplant coordinator instead.

If you would like to know more about how your information is processed or about your data rights, please see the Trust Privacy Notice.

We will confirm receipt within 3 working days via e-mail. If you do not receive confirmation, or are concerned the form did not send, please contact your transplant coordinator.

Telephone numbers for the transplant coordinators are listed on the Oxford Transplant Centre page

(* denotes required fields)

Your Details
Transplant list
Reason
Your Message
Consent

We will use the information provided for the purposes of updating your details on the Oxford transplant list and/or ordering more monthly blood test bottles from the transplant immunology department on your behalf. We will contact you about your request using the contact details supplied in this form.

We will not pass your details onto third parties. For full details of how we collect and use your information, see our Trust privacy notice.

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