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About Your Loved One
Donor's Full Name*
Date of Death
Your Information
Name*
First Last
Former/Maiden Name (if applicable)
I am the donor's*
- Spouse / Significant Other
- Parent
- Child
- Sibling
- Grandparent
- Friend
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Phone*

Have Questions?

Please contact a LifeSource Donor Family Advocate at familyservices@life-source.org or 1-888-536-6283. You may also contact one of our donor family advocates below:

Jill Halimi Donor Family Aftercare Advocate Phone: 612-800-6256 Email: jhalimi@life-source.org Read Bio
Heather Schmitt Donor Family Advocate Phone: 612-800-6249 Email: hschmitt@life-source.org Read Bio

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