Personal Details

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Banner - University Medical Center Tucson

About Your 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.


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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.