Organ Donation Form

I, hereby unequivocally authorise the removal of following organ(s) and/or tissue(s), from my body after being declared brain stem dead by the board of medical experts and consent to donate the same for therapeutic purposes.

Select a organ which you wish to donate

Select a tissue which you wish to donate



By clicking the "I Pledge For Organ Donation" or "Submit" button I authorize For A Cause Charitable Trust to contact me for the formal signing of the Pledge form

Note:

In case of online registration of pledge, one copy of the pledge will be retained by pledger, one by the institution where pledge is made and a hard copy signed by pledger and two witnesses shall be sent to the nodal networking organisation.

Note:

  1. Organ donation is a family decision. Therefore, it is important that you discuss your decision with family members and loved ones so that it will be easier for them to follow through with your wishes.
  2. One copy of the pledge form/pledge card to be with respective networking organisation, one copy to be retained by institution where the pledge is made and one copy to be handed over to the pledger.
  3. The person making the pledge has the option to withdraw the pledge.

CONTACT US


9830239333


033-40619018


chetnakarnani


foracausecharitable-
-trust@gmail.com