First Name *

Last Name *

In as much detail as you're comfortable sharing, tell us about your experience with living kidney donation *

Address One *

Address Two

City *

Zip *

Email *

Phone

Date of Birth *

How did you hear from us? * NHS Transplant Unit Healthcare professional Facebook Instagram X formerly Twitter Google An advert Word of mouth Other

When you submit your story, you're consenting that you're happy for it to be shared on our website, and that it may also be used for e-newsletters, social media channels and fundraising materials produced by us and partner organisations. * I understand, please share my story

If we're working on a particular campaign or project, we might want to get in touch about writing up your story in more detail. Are you happy with that? * I'm happy with this

Would you be willing for us to contact you about sharing your story in the media (eg for a radio interview or news article). Yes No

I would like to sign up to your Mailing List to receive regular updates

Comments

If you have not received a reply from the Make Your Mark Enquiries Team within 3 working days, please check your spam or junk mail folder and add enquiries@donateakidney.co.uk to your Address Book or Safe Sender List.  We make every effort to ensure that these emails are delivered.

You can withdraw your consent for your story to be shared at any time by emailing us at enquiries@donateakidney.co.uk. If you withdraw your consent, we'll no longer use any photos that you have provided previously and we will no longer share your story. Do be aware that any published materials that include this content can't be recalled, but we'll ensure they don't feature in subsequent versions.