Start by telling us more about yourself. You will have an opportunity to approve your profile before it goes live.

Need help?

Please contact and we will assign a transplant ambassador representative to help you complete your online profile.

* Fields are required

** Rather than use your personal email, TAP will provide you will a temporary email address on our secure server that can be used and used on your profile for potential donors to reach out to you.

Social Media Links

Thank you for taking the time to fill out our patient profile questionnaire.

Attach a photo of yourself that is not already used on any social media platforms or, a high resolution image you want to use to represent yourself.

Limit 1,500 characters

Unlimited characters

Video should be no longer than 2 minutes

The Transplant Ambassador Program is not responsible for the result of any actions or interactions between any persons, including potential recipients and potential donors, who have made connections using the information on this website.