Donate Life – Legacy of Hope

Register to become an organ, eye and tissue donor

First Name *

Middle Name (optional)

Last Name *

Suffix (optional)

DOB *

Last 4 of SSN *

Gender *

Address Line 1 *

Address Line 2

City *

State *

ZIP *

Email Address *

This registration is a binding, legal document of gift. You affirm the information provided is accurate. You agree upon death to donate all eligible organs and tissues for transplant, education and research.*

You can update or remove your registration or specify more detailed donation preferences at any time at RegisterMe.org.

View our privacy policy.

The National Donate Life Registry is managed by Donate Life America.

*Per the Alabama Uniform Anatomical Gift Act (UAGA), registration for organ, eye and tissue donation (anatomical gift) includes donation for transplantation, therapy, research, or education.

Date:	09/22/2023
* First Name:
Middle Name:
* Last Name:
Suffix:
* Address 1:
Address 2:
* City:
* State:
* Zip Code:
* Date of Birth:
* Gender:
* Social Security #:
* Email:
Back Confirm

Register to become an organ, eye and tissue donor

Register as a Donor - Confirmation

Register as a Donor - Complete

How to review or update your registration