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Michigan Statutory Uniform Donor Card

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DONATION PURSUANT TO THE
MICHIGAN UNIFORM ANATOMICAL GIFT ACT

(Michigan Consolidated Laws, 333.10104 to 333.10109)

In the hope that I may help others, I hereby make this anatomical gift if medically acceptable, to take effect upon my death. The words and marks below indicate my desires.

I give: (a) any needed organs or physical parts

(b) only the following organs or physical parts

Specify the organ(s) or physical part(s)

For the purposes of transplantation, therapy, medical research or education;

(c) my body for anatomical study if needed.

Limitations or special wishes, if any:

Signed this day of , , 20

Signed by the donor and the following 2 witnesses in the presence of each other:

Signature of donor

Date signed

Witness

Date of birth of donor

City and State

Witness

This is a legal document under the Michigan Uniform Anatomical Gift Act, Michigan Consolidated Laws, 333.10104 to 333.10109.

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What the Michigan Statutory Uniform Donor Card Is

The Michigan Statutory Uniform Donor Card is a standardized legal form used to record an individual's authorization to donate organs, tissues, and eyes for transplantation or research. It establishes the donor's intent in a concise, portable format that health providers and organ procurement organizations can rely on. The card is designed to be consistent with Michigan practice for donor designations and to reduce ambiguity at the time of death; when properly completed it is one way to document consent alongside state donor registries and other advance directives.

Why this donor card matters for clear, documented consent

A completed Michigan Statutory Uniform Donor Card records an unambiguous, legally relevant statement of intent to donate and reduces the need for family decision-making at critical moments. When executed and retained according to applicable laws, the card complements registries and medical records and helps ensure donor wishes are accessible to clinicians and organ procurement organizations. Platforms such as signNow enable secure electronic completion and retention consistent with ESIGN and UETA frameworks.

Why this donor card matters for clear, documented consent

Who typically completes or handles this donor card

Organizations and individuals interact with the donor card at different stages — knowing the typical users clarifies responsibilities.

  • Individuals planning end-of-life or transplant preferences, ensuring their donation choices are documented
  • Hospital intake staff and clinicians who record donor status and attach the card to medical records
  • Organ procurement organizations and state registries that use the card to verify donor authorization

Each party should understand their role: donors sign, healthcare staff record, and registries or procurement groups retain copies for access when needed.

Representative roles who sign or process the card

Donor — Individual

A competent adult completing the card. The donor must sign and date the card to express intent; mismatched identity information can cause verification delays at time of donation.

Clinical Staff — Records

Hospital intake personnel who record donor designation into the medical chart and notify organ procurement organizations, ensuring that the card is linked to clinical documentation available at time of death.

Security and compliance considerations

Encryption: AES-256 at rest
Transport Security: TLS 1.2/1.3 in transit
Audit Trail: Timestamps and action logs
HIPAA: BAA required for PHI
ESIGN / UETA: Electronic signature legality
21 CFR Part 11: Support for FDA-regulated records

Risks of incomplete or incorrect donor cards

Invalid Signature: May be unenforceable
Mismatched Identity: Verification delays
Undated Form: Ambiguous effective date
No Witness/Notary: State-specific concerns
Family Objection: Potential dispute at time of death
Lost Record: Access issues for procurement

How to complete the Michigan Statutory Uniform Donor Card

Follow these practical steps to complete a valid donor card and make it available to care teams and registries.

  • 01
    Obtain the card: Use the official Michigan form or a state-accepted equivalent.
  • 02
    Fill required fields: Enter legal name, DOB, address, and organ/tissue choices accurately.
  • 03
    Sign and date: Provide a handwritten or compliant electronic signature and the execution date.
  • 04
    Distribute copies: Give a copy to your clinician, family, and register with the state donor registry when possible.

How the donor card is used in the donation workflow

The donor card is one piece of evidence considered when donation is evaluated; these are the typical routing steps.

  • Record in Chart: Clinical staff note donor status in the medical record for access during critical care.
  • Notify Procurement: Hospital contacts the organ procurement organization to evaluate suitability.
  • Verify Authorization: Procurement confirms card validity and donor identity before proceeding.
  • Proceed with Donation: If authorized and medically appropriate, donation and recovery proceed per clinical protocols.

Essential elements to include on a professional donor card

A properly completed donor card contains specific data points and clear language of intent so clinicians and procurement agents can verify authorization quickly.

Donor Identity

Full legal name, date of birth, and a government ID reference to help match the donor with medical records and avoid confusion at time of donation.

Contact Information

Current address and a phone number for next of kin or representative, enabling clinicians to notify family and confirm logistical details if needed.

Scope of Donation

Clear selection of organs, tissues, and eyes to be donated; specify any exclusions or limitations to avoid uncertainty during procurement.

Statement of Intent

Unambiguous statutory language authorizing donation that aligns with Michigan practice and can be relied upon by medical staff and procurement organizations.

Signature and Date

Donor signature with execution date; for electronic signatures ensure the method meets ESIGN/UETA criteria for intent and attribution.

Registry Reference

Field for state donor registry ID or indication of electronic registration to assist cross-verification with official records.

Digital workflow settings to manage donor cards

Configure these workflow elements when completing or storing the donor card electronically to ensure accessibility and compliance.

Field Configuration
Authentication Email link or SMS code for signer identity
Signing Order Single-step donor signing; optional witness step
Retention Archive PDF/A with audit trail
Notifications Email to designated contacts and procurement team

Technical considerations for electronic completion

Ensure any eSignature platform meets legal and operational needs for donor card completion and long-term access.

  • HIPAA Controls: BAA availability required
  • Audit Trail: Timestamp and action log
  • Integrations: EHR and registry connectors

Timing and effective date details

Understand when a donor card takes effect and recommended timing for distribution so the document can be acted on when needed.

Effective Date:

Takes effect on the donor's signature date

No Filing Deadline:

No statewide filing deadline; provide card to clinicians or register electronically when possible

Registry Registration:

Registering with the state donor registry makes authorization discoverable at time of care

Update Frequency:

Review and update after major life changes or every few years

Immediate Notification:

Give a copy to next of kin and primary clinician after signing

Real-world scenarios for using the donor card

These two brief scenarios show how the donor card is used in clinical and planning contexts.

Hospital Intake

A patient signs the donor card during admission to record intent for transplantation verification.

  • The card is stored in the medical chart and flagged for procurement review.
  • At time of death the transplant coordinator locates the card and registry entries, confirms authorization with the organ procurement organization, and documents all verification steps in the clinical record for legal and clinical review.

Estate Planning Clinic

An individual completes the donor card while updating estate documents to ensure wishes are aligned.

  • The card accompanies other advance directives in the estate binder.
  • Counsel recommends registering with the state donor registry, distributing copies to family and the primary care clinician, and storing an archived electronic copy with clear instructions for access at time of death.

Practical tips for accurate, reliable completion

Follow these best practices to reduce verification issues and make donor intentions clear to clinicians and registries.

Use official wording
Use the statutory or state-approved donor card language when available to avoid interpretive questions.
Keep records accessible
Provide copies to clinicians, next of kin, and the state donor registry so authorization can be found quickly.
Confirm identity
Ensure names and dates of birth match government ID and medical records to streamline verification.
Review periodically
Revisit the card after relocations, name changes, or major health changes to keep the record current.

FAQs and troubleshooting for the Michigan Statutory Uniform Donor Card

Answers to common questions about validity, revocation, electronic signing, and what happens if the family disagrees.


Need help? Contact support

eSignature vendor pricing and capabilities for document completion

Select an eSignature option that meets legal, security, and operational requirements. The table shows common plan and capability comparisons with signNow listed first.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial Yes, 7-day free trial Varies by plan Varies by plan Varies by plan Varies by plan
Bulk Send Yes Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No

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