Welcome to the BREEZE TRANSPLANT™ online health history questionnaire. This questionnaire will determine your eligibility to match with someone who is in need of a kidney donation.

Tufts Medical Center has performed over 1000 kidney transplants and has become one of the leading medical institutions in the country for kidney transplantation since the program began in 1971.

Please answer all questions truthfully, accurately, and completely. The information that you provide will be used by our Living Donor Team to detect any medical conditions that may affect your ability to be a living donor.

Your privacy is important to us and this questionnaire is confidential. Only health professionals on the Living Donor Team will use this information. This information will not be shared with the transplant candidate or others.

Thank you for your time and participation.