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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 submitted in this form will be emailed to us. Please note that, whilst we will always treat the information you send us with the strictest confidence and will not pass any information on to a third party, emails are not secure and may be intercepted. If you feel concerned about the security of your information when using this form, please telephone your transplant coordinator instead.

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)

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 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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