Willed Body Program Enrollment Forms

If you wish to enroll in this program, please download and complete the forms provided below.

In order to view and print the necessary enrollment forms, you will need to have Adobe Reader installed on your computer. This software can be downloaded and installed free of charge directly from Adobe. For Windows Version or here for other operating systems.

Medical Questionnaire , (download PDF) (download DOC)

Personal Information Form , (download PDF) (download DOC)
At the time of death, the Personal Information form will be used to complete the Certificate of Death required by the State of Arizona. Provide your full middle name even if you do not commonly use it.

Certificate of Donation, (download PDF) (download DOC)
Sign the Certificate of Donation in the presence of two witnesses and also have both witnesses sign the certificate at the same time. Adult family members may act as witnesses. It is not necessary for the Certificate to be notarized. Keep photocopies of the Certificate for your family and medical caretaker.

Thank you for completing these documents and for your thoughtful generosity.