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Mail/Fax Organ Donor Registry
Enrollment Card

To add your name to the Michigan Organ and Tissue Donor Registry, right click on the picture below and choose "Print Picture" in the menu. Then fill out the enrollment card. When the form is completed 1) Fax to (313) 745-4509, or 2) Mail the form to:

 

International Association for Organ Donation

Harper University Hospital

P.O. Box 545

Dearborn, Mi 48121-0545  

 

 

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