Worldwide Cornea Transplant Registry

If you are a cornea recipient and wish to write to your donor's family click here

If you are a member of a donor family and wish to write to your recipient click here

Surgeons, order your cornea tissue online! Complete the following form and we will endeavor to meet your surgical needs. Most requests for cornea tissue are met on the initial requested surgical date.  We endeavor to provide corneas with an overall rating of good-very good-excellent only, and a minimum endothelial cell count of >2400.

If you wish to fax your order you can print the PDF order form here:

Click HERE for Cornea Transplant Order Form 530

Corneas rated as fair are never offered for transplant, domestic or international.  The form below is to list your patient to receive a cornea distributed by California Transplant Services, Inc.

  1. Please provide the following contact information:

    Physician name:
    Hospital or surgery center
    Street Address
    Address (cont.)
    City
    State/Province
    Zip/Postal Code
    Country
    MD's work or mobile phone
    Office Fax number
    Your E-mail address

  2. Please provide the following ordering information:

    QTY DESCRIPTION (Use pull down menu)
    BILLING INFO
    Purchase Order #
    Account Name
    HOSPITAL OR SURGERY CENTER SHIPPING LOCATION
    Street Address
    Address (cont.)
    City
    State/Province
    Zip/Postal Code
    Country

  3. Enter the date of  the surgery :

    -- mm/dd/yy

  4. Enter your patient's name, age and dx in the space provided below: 

    Patient:                    Age:               Dx: Diagnosis:

    Note: All information is held strictly confidential.

  5. Click on "Submit Request" and your patient will be placed on our transplant list!

Send mail to webmaster@catransplant.org with questions or comments about this web site.
Copyright © 2008 California Transplant Services, Inc. All rights reserved.
Revised: June 02, 2011