2023 DLM Collateral Form CLOSED - LifeShare of Oklahoma

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Resources
Stories of Hope
Register Now
- Done Vida
- Wildlife Registration
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Tissue Services
- Refer a Tissue Donor
- Labor of Love Programs >
  - Birth Tissue Donor Program
Innovations Services

Who We Are
Get Involved
Resources
Stories of Hope
Register Now
- Done Vida
- Wildlife Registration
LifeShare Network
Tissue Services
- Refer a Tissue Donor
- Labor of Love Programs >
  - Birth Tissue Donor Program
Innovations Services

Deadline: Feb. 16, 2023 Fill out a separate form for each hospital.

2023 DLM Collateral Form

* Indicates required field

Your Name *

Hospital Name *

Hospital Code

Select Code - This will impact your allocated giveaway items. *

Super A A Transplant Center B C D E F

GUEST SPEAKER

REQUEST *

In Person Speaker Virtual Guest Speaker Recipient for Rounds

Event Date *

Event Time *

Location *

GIVEAWAY REQUESTS (total quantities should not exceed your hospital code allocated amounts)

T-Shirt Qty. Per Sizes

Small *

Medium *

Large *

XL *

2XL *

3XL *

Lapel Pin Qty. *

LIFESHARE DLM MATERIALS

Poster Qty. *

Table Tent Qty. *

Flyer Qty. *

Web Banner - size needed *

Donation Champion Hospital Certificates - Certificate Deadline March 1, 2023

Name and Credentials *

Name and Credentials *

Name and Credentials *

Name and Credentials *

Name and Credentials *

Name and Credentials *

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Name and Credentials *

Name and Credentials *

Name and Credentials *

Name and Credentials *

Name and Credentials *

Name and Credentials *

Name and Credentials *

Name and Credentials *

Name and Credentials *

Name and Credentials *

Name and Credentials *

Name and Credentials *

Name and Credentials *

Name and Credentials *

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Name and Credentials *

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Name and Credentials *

Order Now

LifeShare Transplant Donor Services of Oklahoma
4705 NW Expressway • Oklahoma City, OK 73132
(405) 840-5551

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