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Click ‘Get Form’ to open the anatomical gift form in the editor.
Begin by selecting the specific tissues or organs you wish to donate. Check the appropriate boxes for options like Eyes, Heart, or specify 'Other' if needed.
In the limitations section, clearly state any restrictions regarding your donation preferences.
Proceed to fill in the date of signing and provide your signature in the designated area.
If applicable, have two witnesses sign the form. Ensure they include their names and addresses as required.
Complete the acknowledgment section by filling in details about the judicial district and obtaining a signature from an authorized person.
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Anatomical gift means a donation of all or part of a human body, after death, for the purpose of transplantation, therapy, research or education.
How to make an anatomical gift?
Any adult may make an anatomical gift in writing, including through a will, a donor card or by a statement imprinted or attached to a motor vehicle operators license. When a donor dies, family members should contact the Anatomical Donation Program immediately after the the pronouncement of death.
What does I hereby make an anatomical gift mean?
(3) Anatomical gift means a donation of all or part of a human body to take effect after the donors death for the purpose of transplantation, therapy, research, or education. (4) Decedent means a deceased individual whose body or part is or may be the source of an anatomical gift.
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Would you like to donate $1 or more to the anatomical gift awareness fund? If so, how much? $. VOTER. REGISTRATION. Would you like to register to vote or make
I / You grant permission for: Any testing, examinations, and procedures that may be necessary to determine the medical eligibility of this gift. This includes
Register your intent to become an anatomical donor after death by completing the Instrument of Anatomical Gift form (including attachments), and have it
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