The Colorado Organ and Tissue Donor Registry

Join Today!
Thank you for registering to be an organ and tissue donor. Before you fill out the enrollment form below please take a few minutes to make sure you understand what it means to be on the registry:

By putting your name on the Colorado Organ and Tissue Donor Registry you consent to having all of your organs and tissues made available for transplantation.

You understand that every attempt will be made to transplant your organs and tissues when and where possible and sometimes for medical reasons organs and tissues cannot be transplanted.

Even though your name is on the Colorado Organ and Tissue Donor Registry your family, at the time of your death, will be notified about your decision to be a donor and asked to participate in the process by providing information about your social and medical history.

It is important that you communicate your donation decision to your family so they can help honor and respect your choice.

Once we have received your enrollment form you will be sent a notification card by mail acknowledging that you have been added to the registry.

If you have any questions or would prefer to receive an enrollment form by mail please contact us at 303-380-4802 or 1-888-256-4386.
Fields marked with a * are required fields.

* Select one
Yes, I want to join the Donor Registry.

Please take me out of the Donor Registry.

Your Full Name:

* Last Name:

* First Name:

* Middle:

* Gender: Male     Female

* Date of Birth: (mm/dd/yyyy)    example entry: 04/01/1955

Residential Address:

Street Address:

City,State,Zip:

Mailing Address (if different):

Address or PO Box:

City,State,Zip:

Phone Number (with area code):    enter phone number without dashes
    (ex: 3033294747)

Drivers License or CO ID#:

On your Driver's License, does a "Y" appear in the Donor field (on older licenses), or does a red heart with a "Y" appear in the lower right corner (on new licenses)?

Yes
No
I don't have an ID

The Registry will only accomodate restrictions related to individual organs or tissues that can be removed for purposes of transplantation, medical education or research. Organs are distributed according to national regulations.

List single restrictions (no narrative):