SIGN ME UP TODAY



YES! I wish to donate my organs, tissues, and eyes to save or enhance someone's life through transplantation.

Thank you for registering to be an organ, tissue, and eye donor. Before you register, please take a few minutes to make sure you understand what it means to be on the Registry:
  • Becoming an organ, tissue, and eye donor shares life with others. By putting your name on Georgiaís organ, tissue, and eye donor registry, you agree to have your organs, tissues and eyes made available for transplantation upon death.
  • Examples of organs for life saving transplants include: heart, liver, pancreas, kidneys, lungs, and intestines.
  • Examples of tissue that could save or enhance someone's life include: eyes/corneas, heart valves, bones, and skin grafts.
  • More than 2,800 Georgians are listed for a life saving transplant; over 100,000 are listed throughout the country.

If you have previously registered on this site, you may modify your records by going to:
Update My Profile.

Before you begin you may want to have a printer ready.

Donor Sign-Up Information
All information submitted will be used only for official Registry business and will be kept completely confidential. We will not share, sell, or otherwise compromise this information. For more information, please read our Security and Privacy Policy

If you are under 17 years old, you can join the Donate Life Georgia Registry but, your parents will make the final decision about organ, tissue, and eye donation at the appropriate time.

Email Confirmation
We will confirm your registration by sending an e-mail directly to you. Entering your e-mail address will also allow you to update your information at a later date. If you do not have an e-mail address, you may obtain a free one at Yahoo, Hotmail, or Google.

Required fields are marked with an asterisk (*)
Gender is required.
Gender*

First Name is required.
First Name*
Middle Name is Required.
Middle Name
Last Name is required.
Last Name*
Birth Date is required.
Date of Birth*
Address is required.
Most Recent Address*
City is required.
City*
State is required.
State*
Zip is required.
Zip Code*
Phone
Invalid Email Address
Email Address
  Email Used for Confirmation Only
Mother's Maiden Name is Required.
Mother's Maiden Name*
Drivers License Number/State ID# is required.
Driverís License Number/ ID #*
Place of birth (city,state)
Ethnicity
Required
Password*
(Retype Password*)
  Passwords must be 6 characters long.
How did you learn about the Donate Life Georgia Registry?
Donation Limitations
Would you like to specify donation limitations? A donation limitation is a particular donation you wish to exclude from the Registry and explicitly states you do NOT give your legal authorization for those organs, tissues, and eyes to be recovered. Limitations may include: heart, lungs, liver, kidneys, pancreas, intestine, eyes/cornea, skin grafts, heart for valves, and bones.
 


Yes, I would like to specify limitations for my donation.
 
Terms and Conditions
By submitting this registration I affirm that I am the applicant described on this application and that the information entered herein is true and correct to the best of my knowledge. This registration will serve as a document of gift as outlined in the Georgia Uniform Anatomical Gift Act. A document of gift, not revoked by the donor before death, is irreversible and does not require the agreement of any other person. It also authorizes any examination necessary to ensure the medical acceptability of the anatomical gift.
 
Terms and conditions must be accepted.


Yes, I accept the Terms and Conditions.