Preliminary Search Request Form

A Preliminary Search must be requested by a physician.

The following information is required to start a search for your patient. Search requests received by 3 p.m. (Central time) will be processed the same day.

Submit this form via e-mail or print and fax it to (763) 627-5810. If you have any questions about the status of your request, please call our Patient Support Center at 1(888) 999-6743.

Note: An information packet will automatically be sent to the patient. Information covers the search process through the NMDP*, diseases treatable by stem cell transplants, and a list of the NMDP Transplant Centers.

*The National Marrow Donor Program® (NMDP) operates Be The Match®.

Fields marked with an * are required.

You can request a re-run of a Preliminary Search at any time.