Donor form and instructions

When completing your bequest forms, please make sure the following items are included:

  • Your signature and date signed.
  • Name, Address and telephone number.
  • The lower portion of the form pertains to Health Department Records which aid in completing the death certificate. Please pay close attention to each line, and record accurate information.
  • If you have donated your corneas please make note at the top of the donor form.
  • Two witness signatures are required. These can be your spouse, adult child, neighbor or friend as long as they are at least 18 years of age.
  • After completing the form, please return one to the Body Bequest Office. Please make a copy of the donor form for your records.
  • You will be sent a pocket-sized donor card once the Body Bequest Office receives your form. The card indicates enrollment in the program and the procedures to follow upon death. 

Donor Authorization for Anatomical Gift to Wayne State University Body Bequest Program.

Download:  Word document | Donor form