Organ / Tissue Donor Card
I am a New Zealand citizen

or I am a New Zealand Permanent Resident

In the event of my death, and the suitability of my organs / tissues for transplantation, I would like to donate my organs / tissues and I have spoken to my family about this decision. I wish to donate:
All suitable organs / tissues

or Only the following organs / tissues

_______________________________________________________________
___________________________________________________________
Donor Signature: ___________________________________ Date: _______________
Witness Signature (next-of-kin): _____________________ Date: _______________
Witness Signature: _________________________________ Date: _______________
(It is important to carry this with you at all times)
Organ / Tissue Donor Card
I am a New Zealand citizen

or I am a New Zealand Permanent Resident

In the event of my death, and the suitability of my organs / tissues for transplantation, I would like to donate my organs / tissues and I have spoken to my family about this decision. I wish to donate:
All suitable organs / tissues

or Only the following organs / tissues

_______________________________________________________________
___________________________________________________________
Donor Signature: ___________________________________ Date: _______________
Witness Signature (next-of-kin): _____________________ Date: _______________
Witness Signature: _________________________________ Date: _______________
(Give this copy to your next-of-kin)