Healthcare & Wellness

Organ and Tissue Donation Directive

Legally compliant anatomical gift directive authorizing the donation of organs, tissues, and body parts upon death, consistent with the Revised Uniform Anatomical Gift Act.

📄 1 signer📅 30-day expiry🏷 Healthcare & Wellness🔖 organ-donation, anatomical-gift, end-of-life, directive

About this template

The Organ and Tissue Donation Directive is a ready-to-use healthcare & wellness template you can send for signature in minutes. It is written for 1 signer (donor) and, by default, expires 30 days after it is sent if left unsigned. It covers organ donation, anatomical gift, end of life, directive. Like every Abundera Sign template it is a convenience draft structured for ESIGN Act and UETA compliance, not a substitute for legal advice. Each signed copy is sealed with PAdES-LTA digital signatures, dual RFC 3161 timestamps, and a tamper-evident evidence package in WORM storage.

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# Organ and Tissue Donation Directive **Date:** ___________ **Donor Name:** ___________ **Date of Birth:** ___________ **Address:** ___________ **Driver's License / State ID Number (if applicable):** ___________ **Issuing State:** ___________ ## 1. Declaration of Intent I, ___________, being at least eighteen (18) years of age and of sound mind, hereby make this anatomical gift directive pursuant to the Revised Uniform Anatomical Gift Act (RUAGA) as adopted by my state, and applicable provisions of 42 U.S.C. § 274e (National Organ Transplant Act). It is my intent that this document constitute a valid, legally binding anatomical gift that may not be overridden by my next of kin or any other individual after my death, except to the extent required by law. ## 2. Scope of Donation I authorize the donation of: **Organs:** ___________ **Specific Organs (if applicable):** ___________ **Tissues:** ___________ **Specific Tissues (if applicable):** ___________ **Eyes / Corneas:** ___________ **Whole Body for Medical Education / Research:** ___________ ## 3. Permitted Uses The anatomical gifts authorized above may be used for:

Fields (28)

directive date
date · required
donor full name
text · required
donor dob
date · required
donor address
textarea · required
donor id number
text
donor id state
select
donor full name
text · required
organ scope
select · required
specific organs
textarea
tissue scope
select · required
specific tissues
textarea
eye scope
select · required
body scope
select · required
use transplant
radio · required
use therapy
radio · required
use research
radio · required
use education
radio · required
donation restrictions
textarea
has designated recipient
radio · required
designated recipient name
text
designated recipient relationship
text
transplant center
text
preferred opo
text
nok name
text · required
nok relationship
text · required
nok phone
phone · required
governing state
select · required
donor signer name
text · required

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Send this template with cryptographic proof

Every signed document gets PAdES-LTA digital signatures, dual RFC 3161 timestamps, and a tamper-evident evidence package sealed in WORM storage.

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