Who do I contact if I have questions Sample Clauses

Who do I contact if I have questions. If you have questions at this stage, please call your Living Donor Coordinator at your local transplant centre. You can also contact the Program Co-coordinator of the Australian Paired Kidney Exchange Program in Perth on Ph 00-0000 0000 RECIPIENT PARTICIPATION CONSENT FORM I have reviewed the Australian Paired Kidney Exchange Program “Agreement to Participate” form and procedures with this patient and his/her potential donor. Transplant Coordinator: Date: Transplant Physician/Surgeon: Date: □ I have read this form and all my questions have been answered. □ I have been fully informed about all of my other transplant options for living kidney donation from an incompatible donor □ I hereby consent to participate in the Australian Paired Kidney Exchange Program and understand that I can withdraw my consent for participation at any time without penalty or disadvantage. Name (print): Address: Phone No.: Email: Signed: Date: Copy & send to: Australian Paired Kidney Exchange Program Attention: Program Co-coordinator Department of Nephrology Fremantle Hospital, FREMANTLE WA 6160 Ph 00-0000 0000 Fax 00-0000 0000 DONOR PARTICIPATION CONSENT FORM I have reviewed the Australian Paired Kidney Exchange Program “Agreement to Participate” form and procedures with this donor and his/her potential recipient. Transplant Coordinator: Date: Transplant Physician/Surgeon: Date: Type of donor: directed altruistic □ I have read this form and all my questions have been answered. □ I have been fully informed about all of my other transplant options as a living kidney donor to an incompatible recipient □ I hereby consent to participate in the Australian Paired Kidney Exchange Program and understand that I can withdraw my consent for participation at any time without penalty or disadvantage. Name (print): Address: Phone No.: Email: Signed: Date: Copy & send to: Australian Paired Kidney Exchange Program Attention: Program Co-coordinator Department of Nephrology Fremantle Hospital, FREMANTLE WA 6160 Ph 00-0000 0000
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Who do I contact if I have questions. If you have any questions or for more information about the lawsuit or settlement, contact the Settlement Administrator or Class Counsel at: Settlement Administrator Class Counsel

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