Restore Lives by Registering to Become a Donor Below

To register to become an organ and tissue donor in Arkansas, simply complete and submit the form below. It only takes a few minutes but, through its life-restoring potential, donor registration can impact peoples’ lives for years to come.

I wish to donate my organs, eyes, and tissues to save or enhance the lives of others.

If you would like to be a donor, but DO NOT live in the State of Arkansas, visit www.donatelife.net to learn how to register in your home state.

Do you have an Arkansas Driver License? If yes, please register using your Arkansas Driver License Number (This will ensure that your registration preferences will be in sync with the Arkansas DMV record).

Arkansas Drivers License or State ID
Gender
Register as a donor - Consent *