Donation Printable Form - med umich 2025

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  1. Click ‘Get Form’ to open the Donation Printable Form in the editor.
  2. Begin by entering your donation amount in the 'Enclosed is my gift of $' field. Ensure this reflects the total you wish to contribute.
  3. Select the areas you would like to support by checking all applicable boxes under 'I would like to support'. If no designation is made, your gift will be allocated to the area of greatest need.
  4. Provide your payment information. Choose whether you are paying by check or credit card. If using a credit card, fill in the required details including card type, name on card, number, and expiration date.
  5. Complete your personal information by filling in your name, address, city, state, zip code, phone number, and email address.
  6. If applicable, indicate if your gift is in honor or memory of someone and provide their details for notification.
  7. Review all entered information for accuracy before saving or printing the form for submission via mail, fax, or email as indicated at the bottom of the form.

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The potential donor had an infectious or contagious disease such as /AIDS, hepatitis B, hepatitis C, tuberculosis, active MRSA or prion diseases. The next of kin objects to the donation of the body, the family is not in agreement or there is family discord.
At the time of death at a location outside of Michigan Medicine, a funeral home must be contracted and advised to contact the University of Michigan Medical School Anatomical Donations Program to determine whether the Program can accept the anatomical gift of the donors body and to obtain instructions regarding
Upon completion of medical studies, which is usually one to four years after we have received the body, the bodies are individually cremated and one of the two options is followed: First, the ashes can be returned to the family or to a location selected by the family for final interment.
In order for HMS to accept your self-donation after your death, the following requirements must be fulfilled: Immediately upon your death, your next of kin must notify HMS by calling 617-432-1735 during business hours, or 617-432-1379 after hours or during weekends/holidays, to alert HMS of your death.
To donate your body, we recommend the follow steps: Discuss your wishes with family and friends. Contact your nearest medical school for further information. Complete the consent form they provide. Keep a copy of the form with your will. Tell your family, close friends, executor and doctor of your intention to donate.
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Individuals who are interested in becoming donors to this program are required to complete three forms to formalize this process: the donation form, signed by the donor and witnessed by two individuals, a vital statistics form, and a brief medical history form.

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