Personal Details

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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.