Personal Information (Please use legal name.)

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About Your Donation

 




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I understand that by signing up for the Donate Life Missouri Registry, I am making a legal gift. This gift does not need anyone else's permission. I understand that I can change my mind about donating all or some of my organs and tissues. I understand that I can take my name off the Donatelife Missouri Registry online, by sending a paper form in the mail, or by going to my local DMV office.

By signing this online form, I confirm that I am the person named above, and that all information provided is accurate and true. I have read and understand the informed consent and the privacy policy.