Confirmation Page

Thank you for registering as an organ donor.

 

Dear FName,

Please print out your organ donor card below. You may cut it along the lines and keep it in your wallet.
 


 

 

Donor Name:

FName LName

Donor Signature:

 

Witness(es):

Who_have_you_shared_your_decision_with

Gender:

Gender



 


If you have any questions on organ donation, please feel free to contact us


Here is some additional information on Organ Donation

Who can become a donor?
People of all ages and medical histories should consider themselves potential organ, tissue and eye donors. Your medical condition at the time of death will determine what can be donated. Because of the critical need for more deceased donors, there is also a growing number of living donors. Living
donation can include a kidney, part of a lung or part of a liver.

What can I donate?
Organs: heart, kidneys, pancreas, lungs, liver and intestines.
Tissues: cornea/eye, skin, bone, heart valves, veins and tendons.

Why isn’t signing the back of my driver’s license enough?
The Gift of Life Donor Registry is the only document that is accessed at the time of death regarding organ and tissue donation. In most cases, the driver’s license is never located to determine a person’s desire to become a donor.

Will doctors work as hard to save my life if they know I am an organ, tissue and eye donor?
Yes, every effort is made to save your life before donation is considered. By law, the medical team treating you must be separate from the transplant team.

Are there any costs to my family?
No, it costs nothing to donate and no costs are passed on to the donor’s family or estate.

Can normal funeral arrangements be made?
Yes, donation does not interfere with having a funeral, including open casket services.

Will my religion approve of donation?
Most major religions approve of organ, tissue and eye donation, and consider donation an act of charity.

Do rich and famous people wait less time for a transplant?
No, the organ donation allocation system is blind to wealth or social status. The length of time it takes to receive a transplant is governed by many factors, including blood type, length of time on the national waiting list, severity of illness and other criteria.