1. Write to us your country / city name from where you are seeking medical opinion with your full contact details.

2. Send by email or by post copy of recent clinical observations / diagnosis / medical report translated into English.

3. Send images in JPEG file format.

4. Send us your age, test results for BP, Urinalysis, Bun, Potassium Tests, Renal or Abdomen X-Ray's, Abdominal Ct Scan, Abdominal MRI, HLA match with siblings test results, urinary Casts, PTH results, Serum Magnesium test, and all relevant Pathological Reports or a summery of observations on them.

5. Cause of Patient Kidney Failure

6. Have you ever had a kidney biopsy? Yes / No
If Yes, Date (in dd/mm/yyyy format)

7. Are you on dialysis? Yes / No
Type of Dialysis
Date (in dd/mm/yyyy format) of First Dialysis
Dialysis Days / Time

8. Why did your transplanted kidney stop working?
When did your transplanted kidney stop working?

9. List other operations and dates.

10. Have you been hospitalized for any other illness? Yes / No
If yes, please give dates / reasons and hospital names, if known.

11. List all current medications

12. Known allergies (Medications and Other Allergies)
Habits (such as Smoking / Alcoholic Beverages / Recreational Drugs)

13. Are you diabetic? Yes / No
Age you became diabetic

14. Do you take insulin? Yes / No
Age you began taking insulin

15. Do you take pills to control sugar?
Yes / No
Do you have high blood pressure?
Yes / No
How long?
How treated?

16. Have you ever had a stroke?
Yes / No
Date

17. Patient Blood Group
Near Relative of Patient Donor Blood Group

18. Have you ever had a transfusion?
Yes / No
Are you willing to accept transfusions? Yes / No
How many units of blood have you had in your lifetime?
Approximate date of last transfusion

19. Do you have HLA Match with siblings record (please mention)

20. Any other information you believe is important for us to know about your medical history (for example physical disabilities, limitations, handicaps etc.).