Advance Directives
ORGAN DONATION ADDENDUM
[Note: If you want to be an organ donor, you can attach this page to your living will or advance directive. Sign it and have it witnessed.]
I direct that if I am brain dead, an anatomical gift be offered on my behalf to a patient in need of an organ or tissue transplant. If a transplant occurs, I want artificial heart/lung support devices to be continued on my behalf only until organ or tissue suitability of the patient is confirmed and organ or tissue recovery has taken place.
By signing below, I indicate that I am emotionally and mentally competent to make this organ donation addendum and that I understand the purpose and effect of this document.
(Date)________________________
(Signature of Declarant)___________________________________________
The declarant signed or acknowledged signing this organ donation addendum in my presence and based upon my personal observation appears to be a competent individual.
(Witness Signature)
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(Witness Signature)
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