Superior's Sign Up to Save Lives! - Texas Donor Registry

Superior’s Sign Up to Save Lives!

Did you know that one organ, eye and tissue donor can save eight lives and enhance the lives of up to 75 others? Donors can enhance the lives of so many, including burn victims, breast cancer survivors, restoring someone’s sight, and those waiting for a lifesaving organ transplant. This is why registering your donation decision is so important.

Superior is partnering with South Texas Blood & Tissue Center and Texas Organ Sharing Alliance (TOSA) to encourage employees to learn the facts about donation, then sign up to save lives!

The Donate Life Texas Registry is the official organ, eye, and tissue donor registry for the state of Texas. By registering, you can record your legal consent for organ, eye, and tissue donation.

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https://donatelifetexas.org/superior/

Register As A Donor

Gender*

male female

First Name*

Middle Name

Last Name*

Date of Birth (ex: MM/DD/YYYY)*

Most Recent Address*

City*

State*

Not from Texas? Visit Donate Life America to find the registry for your state.

ZIP Code*

Phone

E-mail Address*

Place of Birth (City, State)

Ethnicity

PLEASE PROVIDE ONE OF THE FOLLOWING:

SSN# (Last Four Digits)

Texas Driver License/Personal ID:

Mother's Maiden Name

How did you learn about the Texas Donor Registry?

Please Specify

I would like to donate:

all organs and tissues for transplant and for research, education or therapy purposes if they are determined unsuitable for transplant
all organs and tissues for transplant only
to specify my gift of donation on the next page

Have you signed up for a Body Donation Program? If so, please indicate which program:

Electronic Signature Certification
I understand this online registration remains binding after my death. I do solemnly swear, affirm or certify that I am the applicant described in application, and that the information entered herein is true and correct. By clicking the submit button I affirm that I wish to be a potential organ donor and/or tissue donor upon my death.

Yes, I accept the Electronic Signature Certification.

Donate Life Texas

Registered Donors

Transplant Waiting List

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