Organ Donor Register
Name: Address: : : Email: Phone:

I want to be an organ and tissue donor to help save lives. I would like to donate:

All of my organs & tissue
Heart Lungs
Kidneys Liver
Pancreas Corneas
Heart valves Bones



Irish Kidney Association
Donor House
Block 43A
Dublin 12

LoCall: 1890-543639
Tel: 353-1-6205306
Fax: 353-1-6205366

© Eilis Buckley 2013