Fillable Form Organ Donation

What is an Organ Donation Form?

An Organ Donation form is a legal document used by an individual to give his or her consent to donate organs, tissues, or body parts after passing away. You may use the Organ Donation form for the following purposes:

• To legally put in writing your intention to donate organs or tissues.
• To let your family members know what you wanted to do with your body after your death.
• To specify the organs or tissues you wish to donate.
• To specify the recipient or recipients of your organ donation.
• To include other terms and conditions of your organ donation.

How to fill out an Organ Donation Form?

For your convenience, PDFRun has an Organ Donation form template that you can use. It should be filled out with the following information:

First paragraph

Enter your full legal name.

Enter the organization you’re affiliated with.

Second paragraph

Mark the appropriate item to determine the organs, tissues, or body parts you are willing to donate. You may select:

• Any needed organs, tissues, or parts
• Any needed organs, tissues, or parts except my:
• The following organs, tissues, or parts only:

If you choose the second statement, enter the specific organs, tissues, or parts you will not donate.

If you choose the third statement, enter the specific organs, tissues, or parts you will donate.

Third paragraph

Mark the appropriate item to determine how you want your donation to be used. You may select:

• Any purpose authorized by law.
• The following purpose only:

Initial all that apply.

• Transplantation
• Research
• Therapy
• Education

Fourth paragraph

Enter specific details about limitations or special wishes you would like to indicate in this form.

Fifth paragraph

Enter the name of the recipient(s) of your organ donation.

Sixth paragraph

Mark the appropriate item to determine your alternative recipient. You may select:

• My organs, tissues, or parts be given to any authorized donee.
• My organs, tissues, or parts not be donated at death.

Donor’s Signature

Affix your signature.

Donor’s Name

Enter your full legal name.

Witness’ Signature

Affix the signature of the first witness.

Witness’ Name

Enter the full legal name of the first witness.

Witness’ Signature

Affix the signature of the second witness.

Witness’ Name

Enter the full legal name of the second witness.

Frequently Asked Questions About an Organ Donation Form

Who can donate an organ or tissue?

Everyone who is willing to donate an organ or tissue can be a potential donor. Even if you have a health problem, you will be considered to become an organ donor upon death. However, there are some conditions that might restrict a person from becoming a donor, some of these are:

• Active cancer
• Human Immunodeficiency Virus (HIV)
• Systemic infection
• People aged 18 below when the occasion for donation arises

A parent’s consent must be presented to go through with the organ donation.

What organs and tissues can be transplanted?

Organ transplantation is one of the things that can be done to an organ donation. It is a process where an organ or tissue of the donor will be transplanted to another person legally. Here are some of the organs that you may donate to be transplanted:

• Liver
• Kidney
• Pancreas
• Heart
• Lung
• Corneas
• Bone marrow

Why should I become an organ donor?

If you have been thinking of donating your organs, tissues, or other body parts upon death, here are a few suggestions why you should go through it:

• It means a ‘new life’ to the recipients of your organ donation.

Becoming an organ donor means having the opportunity to help people who are ill, especially those who are under a critical condition. Receiving an organ gives hope to these people that they may continue living their life. One’s ending might result in another person’s start to living fully again.

• It can help the grieving process of your loved ones.

Your family and friends can find comfort in knowing that their loved one’s body parts are being used to help save the life of other people. It might help them in dealing with your loss and finding peace with it.

• One organ donor can help multiple people.

With a lot of people on the organ waiting list, you will have the chance to help more than one of them. Being an organ donor can make a profound difference and positively impact lots of lives.

• It can be used for medical research.

You may opt to donate your organs or whole body to a hospital or any medical research facility. Your body will be used to perform experiments. You can save even more lives by doing this because you will provide them the materials or resources they need to find cures for various complex medical conditions.

• Qualified organ donors are very rare.

Even though an individual is already registered as an organ donor and has given his or her consent for organ donation, his body still needs to be examined for a medical assessment and evaluation for donor suitability. This process will determine if he or she is eligible for organ donation after death. If you add yourself to the list, you might help in increasing the number of qualified organ donors and the odds of survival.

Tips on how to become an organ donor:

Step 1: Ask yourself a lot of questions about becoming an organ donor. It is a big and important decision so you have to be certain if you’ll go through it. Do not be swayed by other people’s opinions, remember that it’s your body and the decision is yours alone.

Step 2: Talk to your family and friends about your decision. Letting them know your intention to become an organ donor might also encourage them to do the same.

Step 3: Inquire in your state’s donor registry about the requirements you need to pass to become an organ donor.

Step 4: Fill out an Organ Donation form.

Step 5: Submit the Organ Donation form along with the other requirements to your state’s donor registry.

Step 6: After registering, verify if your name is included in the list of possible donors in your state.