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ANATOMICAL GIFT Forming the event of my death, I donate the following part(s) of my body for the purposes identified in AS 13.52.170:Tissue: Eyes: Bone and connective tissue: Skin: Heart: Other: Limitations:
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How to fill out anatomical gift form

01
Start by obtaining an anatomical gift form from a reputable source such as a hospital, organ procurement organization, or your state's department of health.
02
Read through the form carefully to understand the information and sections it requires.
03
Provide your personal information in the designated sections of the form, including your full name, address, date of birth, and contact details.
04
Specify your intentions regarding organ, tissue, or body donation by checking the appropriate boxes or providing detailed instructions.
05
If you have any specific preferences or restrictions regarding the use of your gift, clearly mention them in the provided space.
06
Consider designating a primary and alternate person as your healthcare agent who is authorized to make decisions regarding your anatomical gift.
07
Review the completed form to ensure all the necessary information has been provided and it is legible.
08
Sign and date the form in the presence of two witnesses who are not related to you or potential beneficiaries of the gift.
09
Make copies of the completed form for your personal records and distribute them to your healthcare agent, family members, attorney, and any other relevant parties.
10
Periodically review and update the form as per your changing preferences or circumstances.
11
Store the completed form in a safe and easily accessible location.

Who needs anatomical gift form?

01
Anyone who wishes to donate their organs, tissues, or their body after death can benefit from filling out an anatomical gift form.
02
These forms are especially useful for individuals who have specific preferences or restrictions regarding how their gift should be used or who they want as their healthcare agent.
03
Anatomical gift forms can be completed by people of any age or health status, as long as they meet the criteria of the applicable laws and regulations.

What is Anatomical gift - Alaska Form?

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An anatomical gift form is a legal document that allows an individual to donate their organs or tissues for transplantation or medical research after death.
Individuals who wish to donate their organs or tissues after death are required to file an anatomical gift form.
To fill out an anatomical gift form, an individual needs to provide personal information such as name, address, and signature, along with a clear indication of the intent to donate specific organs or tissues.
The purpose of the anatomical gift form is to legally document a person's wish to donate their organs and tissues, ensuring that their intentions are followed after their death.
The anatomical gift form must report the donor's full name, address, date of birth, signature, and specific instructions regarding which organs or tissues are to be donated.
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