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Phone 24 hrs: 206.682.8502 Domestic Surgical Tissue Request Form or 8776828502 Faxes: 206.682.8504 PLEASE PRINT Surgeon: Today's Date Contact Person: Tel:(direct office number) Please complete Patient
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How to fill out Northwest Lions Eye Bank:

01
Visit the official website of Northwest Lions Eye Bank.
02
Look for the "Donor Registration" or "Become a Donor" section.
03
Fill in your personal details such as name, contact information, and address.
04
Verify your eligibility to be an eye donor by answering the required questions.
05
Provide any additional medical information or history as requested.
06
Review and agree to the terms and conditions of becoming an eye donor.
07
Submit the completed form either online or by mail, depending on the instructions provided.

Who needs Northwest Lions Eye Bank:

01
People suffering from corneal diseases or conditions that affect their vision.
02
Individuals who have damaged or diseased corneas and require a corneal transplant.
03
Ophthalmologists and eye surgeons who perform corneal transplant surgeries.
04
Eye banks and transplant centers looking for a supply of healthy corneas for transplantation.
05
Researchers and scientists working on advances in corneal transplant techniques and treatments.
06
Donor families who want to honor their loved ones' wishes of eye donation and potentially help others regain their sight.
Note: The Northwest Lions Eye Bank specifically serves the region it is based in. Similar eye banks exist in different locations, catering to their respective communities.
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Northwest Lions Eye Bank is a non-profit organization that helps to facilitate eye donation and transplantation in the Northwest region.
Medical professionals and healthcare providers are required to file with the Northwest Lions Eye Bank when a potential eye donation is identified.
To fill out the Northwest Lions Eye Bank form, medical professionals must provide accurate information about the donor's medical history and cause of death.
The purpose of Northwest Lions Eye Bank is to help restore vision and prevent blindness through eye donation and transplantation.
Information such as the donor's medical history, cause of death, and contact information of the medical professional overseeing the donation must be reported on Northwest Lions Eye Bank forms.
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