Instructions for Pre-Registration Paperwork
How To Fill Out Your Paperwork
1.You have downloaded the following forms:
Donor Information Sheet
Medical/Social History Questionnaire
Information Required for the Death Certificate
Anatomical Gift of Whole Body by a Living Donor
2.PLEASE PRINT CLEARLY. We must be able to read all information.
3.Fill in all blanks. If something is not known, just write “unknown” in the space.
4.The Anatomical Gift of Whole Body by a Living Donor form must be signed by the donor themselves. It cannot be signed by someone acting on the donor’s behalf such as a POA. If it cannot be signed, we will get a recorded consent by the donor’s NOK upon death.
5.On the Medical/Social History Questionnaire, if you answer yes to any question, please explain in as much detail as possible.
6.We suggest you make photocopies of the completed forms for your records.
7.Mail all original forms to: Anatomy Gifts Registry
500 McCormick Drive, Suite E
Glen Burnie, Maryland 21061
Once We Receive Your Paperwork
1.We will review your paperwork and contact you with any concerns or questions.
2.Upon approval, we will issue you a registration number and mail you an acceptance letter and two laminated donor cards.
3.The cards will include your and registration number on the front and the procedure to follow at the time of death on the back.
4.Keep one card in your wallet and give the other to your next-of-kin.
5.Feel free to photocopy the cards and give them to anyone you think should have this information such as other relatives, your doctor, friends, and neighbors.
6.Please contact us immediately with any changes to your address, phone number, and medical history.
Thank you for your interest in our program!
Forms as PDF Downloads
