Be a hero: Join the Science Care Registry today
You do NOT need to register below if:
A death has occurred
Instead of registering below, please call us at (800) 417-3747 ext. 1.
The patient is terminally ill, or under hospice/palliative care
Instead of filling out the form below, please call us at (800) 417-3747 ext. 2 or fill our the HOPE® form.
You have a new address, new contact info, or need to complete a consent form
If you’ve already registered with Science Care, please update your contact information, download a replacement card, or complete the self-consent form.
We currently pre-register persons living in AZ, CA, CO, DE, FL, IN, IL, NV, OR, PA, TX, WA and WI. If you do not live in one of these states, simply tell your loved ones that you wish to be a donor so they are aware to call Science Care either at your entry into hospice care or at the time of need.
Please complete the form as accurately as possible. Misspelled names, addresses, phone numbers, and emails can delay or cause issues with your registration.
Science Care Donor Registration Form
* You have left some required fields empty. Please correct fields in red.
IMPORTANT NEXT STEP!
Complete the “Donation and Cremation Consent Authorization” form
After completing the online registration form above, you will be taken to a web page with a link to complete and download the “Donation and Cremation Consent Authorization Form.” The form must be completed, initialed, printed, signed and dated by the registrant, and signed by two witnesses.
