International Association for Organ Donation- tissue donor!

Online Organ and Tissue Donor
Enrollment Card

Thank you for your interest in registering as an organ and tissue donor. Please remember to share your wishes with your family members. They will be able to ensure that your wishes are fulfilled.

NOTE: Fields with an asterisk * must be completed.

Driver License or Personal ID Number:
*Name:
*Date of Birth:
Male Female
*Street address:
*City or Township:
*State:
*Zip:

The information you provide is forwarded to IAOD for inclusion on Michigan's Organ and Tissue Donor Registry.