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Select one Event Facebook Instagram MVD Other Radio Television Twitter 1 Stop Title & Registration Services 1Stop Money Centers 4 million AADA Abnormal Hearts Abrazo Arizona Heart Hospital Abrazo Arrowhead Campus Abrazo Central Campus Abrazo Scottsdale Campus Abrazo West Campus Adelante Healthcare Advertising Agua Fria High School Alpha Graphics Camelback Amanda Hope Rainbow Angels American Heart Association American Liver Foundation Andrada Polytechnic High School Arizona Chapter National Safety Council - Defensive Driving School Arizona Department of Education Arizona End of Life Care Partnership Arizona Funeral Cemetery and Cremation Association Arizona General Hospital - Laveen Arizona General Hospital - Mesa Arizona Glaucoma Specialists Arizona Healthcare Directive Registry Arizona Healthcare Directives Registry Arizona Humane Society Arizona Motor Vehicle Express LLC Arizona Spine and Joint Hospital Arizona Transplant Associates Ashley Siegel ASU SODA Auto Wellness Ayryonna Davis AZ Optical Systems AZBlue B For Life Banner Baywood Medical Center Banner Boswell Medical Center Banner Cardon Children’s Medical Center Banner Children's of Desert Banner Del E Webb Medical Center Banner Desert Medical Center Banner Estrella Medical Center Banner Gateway Medical Center Banner Goldfield Medical Center Banner Health Banner Heart Hospital Banner Ironwood Medical Center Banner Ocotillo Medical Center Banner Payson Medical Center Banner Thunderbird Medical Center Barnet Dulaney Perkins Eye Center Basha High School Basha High School Before I Die Festival Benson High School Benson Hospital Banner Ocotillo Biltmore Eye Physicians Blue Cross Blue Shield of Arizona BreyerLaw Bright Ideas Childcare Brophy College Preparatory Buckeye Union High School BUMC - Phoenix BUMC - Tucson Business Cancer Treatment Centers of America Canyon View High School Canyon Vista Medical Center Capitol Carl T Hayden VA Medical Center Carondelet St. Joseph's Hospital Carondelet St. Mary's Hospital Catalina Foothills High School Central Arizona Valley Institute of Technology (CAVIT) Cfjamin Chandler Regional Medical Center Church Cinco de Mayo Festival Phoenix Clear Vision Opthalmology Combs High School Copper Queen Community Hospital Cornea & Cataract Consultants of America CPLC Creative Testing Solutions CTCA at Western Regional Medical Center Curahealth Hospitals Phoenix Northwest Danika Arce darionpadilla darionpadilla Desert Edge High School Desert Lawn Funeral Home Desert Sage School - Drivers Ed Desert Title Motor Vehicle Services Desert Title Motor Vehicle Services - Gilbert, AZ Diamondbacks Dignity Arizona General Hospital Donate Life Month Donate Life Month QR Code Donor Network of Arizona Driver Compliance Dysart High School Earnhardt Auto Center East Valley Institute of Technology (EVIT) Eblast Ellary Burk Estrella Foothills High School Evergreen Mortuary, Cemetery and Crematory EVIT East EVIT East 39265 EVIT East 39370 Example Family Fiesta Bowl Parade FirstResponders Flagstaff Medical Center Flying Basset Brewing FooteWork Fresenius Kidney Care Friend Funeral Home Gallagher GB Family Care GG&D Motor Vehicle Services Gila Ridge High School Ginger's Auto Title Service Girl Scouts Goodwill Goodwill of Southern Arizona Goodyear CDL Field Office Green Valley Hospital Greenwood Greg Welsh Haps BBQ Harmony Medical HDS Marketing HealthSouth Scottsdale Rehabilitation Hospital Home Assist Health Honeywell HonorHealth Deer Valley Medical Center HonorHealth John C. Lincoln Medical Center HonorHealth Scottsdale Osborn Medical Center HonorHealth Scottsdale Shea Medical Center HonorHealth Scottsdale Thompson Peak Medical Center Hope Heart Heal HOSA Fall Leadership Conference HOSA Virtual Donation Education Hospital In & Out Tags and Title Services In Honor of a Donor Internet Jefferson Elementary School No Content for "hau_JFC" Julianne Orren Juneteenth Kidney Walk Knights of Columbus Kofa High School La Joya Community High School Larry H. 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Tiffany Avelar TigerMountain TMI Tonopah Valley High School Transplant Community Alliance Transplant Families Transplant Families Trinity Air Medical Tucson Medical Center Tucson Weekly Tucson Weekly United Surgical Partners United Tissue Network Unity of Phoenix The University of Arizona Univision USPHS - Whiteriver Indian Hospital Valente Caywood Valley Academy for Career and Technology (VACTE) Valleywise Health Virtual Donor Remembrance Volunteer Walden Grove Band Walgreens West - MEC 39443 West - MEC SW West-MEC HOSA chapter 39398 West-MEC Northwest Western Arizona Regional Medical Center Wickenburg Community Hospital Wilcox High School Williams Field High School Willow Canyon High School Winslow High School Workplace Yard sign Yavapai College Yavapai Regional Medical Center Yavapai Regional Medical Center- East Campus Yavapai Regional Medical Center- West Campus Youngker High School YouTube Yuma Regional Medical Center Intended Purpose* Transplant and research Transplant I agree that detailed information regarding my donation, from recovery through transplantation, has been made available to me through this registration. By submitting this registration I affirm that I am the applicant described on this application and that the information entered herein is true and correct to the best of my knowledge. This registration will serve as a registration of my document of gift as outlined in the Arizona Uniform Anatomical Gift Act. A document of gift not revoked by the donor before death is irreversible and does not require the authorization of any other person. More information about your donor registration The following information is intended to provide you with information on the process of donation. If you have any questions or would like further explanation on this section, please call Donor Network of Arizona at 800-94-DONOR (800-943-6667). I understand and authorize the following as indicated by my signature for authorization at the end of this document: Donation requires both a physician’s legal declaration of death and the decision to help others. There is no cost to the family or estate for anything related to the donation. All unrelated hospital charges as well as funeral expenses remain the responsibility of the family or estate. The privacy and the confidentiality of the donor and the decision for donation will be respected. Information will be shared with those individuals and organizations involved in the donation process; this will include hospital and transplantation staff, the funeral provider and the medical examiner’s office. Copies of medical records, the death certificate and the autopsy report, if there is one, will be obtained and reviewed. Part of the donor evaluation process requires transmissible disease testing. These tests are performed to ensure the safety of transplant recipients. Arizona laws requires that positive confirmed tests be reported to the Arizona Department of Health Services. Other evaluative tests, procedures and biopsies may also be performed. For organ donation, the recovery of the spleen and lymph nodes takes place to ensure the compatibility between the donor and transplant recipients. Blood vessels may also be recovered for the purpose of safe organ transplantation. The placement of organs and tissues is directed by local, state and federal guidelines and transplantation standards. At times, tissue may be sent to help people in other countries. Through medical breakthroughs, recovered tissue can be reshaped and reformed to accommodate a variety of transplant needs. Also, in order to benefit the greatest number of recipients, both nonprofit and for-profit organizations may be involved in the process. The work of recovery in the donation process is performed with care and does not normally interfere with funeral arrangements. Donation includes the careful restoration of the donor. Bruising and swelling are rare but can occur. For tissue donation, the donor may be transported to a donation facility for recovery procedures. The medical examiner’s office will determine if an evaluation or autopsy is necessary and if any restrictions regarding the donation process are required. Following the recovery of anatomical gifts and the medical examiner’s evaluation (if applicable), funeral plans and/or other arrangements may proceed. Congratulations! You have successfully registered! Congratulations, you are officially a registered donor in the state of Arizona. Thank you for joining the millions of Arizonans who have also made the commitment to saving and improving the lives of others. Please print and retain the Donor Confirmation Letter for your records, as you will not receive anything by mail. Join our social media community to share inspiring stories of hope and learn more about organ and tissue donation. Send an email or postcard to your family and friends to let them know you are a registered donor. Add your name or add a loved one’s name to the Wall of life. To remove your registration as an organ and tissue donor in the DonateLifeAZ Registry, click here. All other profile changes and specifications can be made by clicking "edit" below. Logout of your donor profile. About Your Donation I wish to donate any needed organs/eye/tissues I wish to specify my donation Check "no" to any items that you DO NOT wish to donate. Click an item name for more detailed information about that item or items. Organs Heart Yes No Kidneys Yes No Small Intestine Yes No Lungs Yes No Liver Yes No Pancreas Yes No Tissues Eyes Yes No Heart (For Valves) Yes No Bone & Associated Tissue Yes No Skin Tissue Yes No Veins & Arteries Yes No Pericardium Yes No ×Close Authentication In order to edit your information in the future, please enter a password that is at least 8 characters long with at least two of the following - capitals, numbers, symbols. Submit