Join the Donor Registry

If you would like to enroll in the New York State Organ & Tissue Donor Registry, please provide the information requested below. Within a few weeks you will receive a confirmation letter from the Commissioner of the New York State Health Department.

Thank you!

In order for your Donate Life Organ and Tissue Donor Registry Enrollment Form to be filed as a legal document with the New York State Department of Health, we ask that you please print out the form, fill out all the required information, and sign at the bottom. Please mail your completed enrollment form directly to the address provided

Donate Life Organ and Tissue Donor Registry:
downlod the PDF file