Donor Registration

I understand that:

  1. A copy of this consent documentation will be mailed to me for my records.
  2. This donation is being made voluntarily without any compensation and that I may revoke or amend this gift at any time prior to my death and neither my estate nor my next of kin will ever be charged by TFL for the costs related to this donation.
  3. This donation will involve the surgical removal of transplantable tissues from the body.
  4. This donation is being made in accordance with all applicable aspects of each state’s Revised Uniform Anatomical Gift Act. 
  5. There is no guarantee that transplant donation will take place.
  6. My body will be treated with as much care, respect and dignity as possible throughout the entire donation process.
  7. TFL is a for-profit program that may use tissues recovered for transplant both domestically and internationally by both for-profit and not-for-profit processors.
  8. All information collected by TFL will be protected as governed by the United States Health Insurance Portability and Accountability.
  9. The body will be transported to a contracted TFL facility for serological and biological screening of blood for Hepatitis B, Hepatitis C, Human Immunodeficiency Virus (HIV) and any other communicable diseases. All positive test results are subject to state reporting as per applicable state laws.
  10. Recovered tissues may be processed into different forms depending on their intended use.

I agree to:

  1. Hold harmless TFL employees, any funeral director / funeral home/ crematory, their agent, or processors from any and all loss or damage, including incidental and consequential damage incurred while TFL acts in good faith.
  2. Allow TFL to obtain any and all medical information including, but not limited to doctor, hospice, hospital, autopsy records, certified copy of death certificate in order to best determine medical suitability for this donation.

I authorize:

  1. I hereby authorize that my remains may be used for transplantation. Any remains not suitable for transplantation may be used for research and education purposes.
  2. After careful consideration and after having all of my questions answered, I hereby direct TFL to proceed with the donation process (upon notification of my death) as per all of the conditions/disclosures listed above.
  3. I hereby direct any hospital, hospice, medical examiner, or coroner to make available my remains in a timely manner to Transplant for Life to facilitate my directive to be a transplant donor.

Transplant For Life Registration Form

For SELF: Download Form.

For Next of Kin (NOK): Download Form.

* Required