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Session Laws, 2005
Volume 752, Page 956   View pdf image
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Ch. 137                                    2005 LAWS OF MARYLAND c. If I am pregnant my agent shall follow these specific instructions:
____________________________________________________________________________ ____________________________________________________________________________
d. Upon my death, I wish to donate: ______ Any needed organs, tissues, or eyes. ______ Only the following organs, tissues, or eyes:
_____________________________________________________________________________ ___________________________________________________________________________
I authorize the use of my organs, tissues, or eyes: ______ For transplantation ______ For therapy ______ For research ______ For medical education ______ For any purpose authorized by law. I understand that before any vital organ, tissue, or eye may be removed for
transplantation, I must be pronounced dead. After death, I direct that all support
measures be continued to maintain the viability for transplantation of my organs,
tissues, and eyes until organ, tissue, and eye recovery has been completed. I understand that my estate will not be charged for any costs associated with my
decision to donate my organs, tissues, or eyes or the actual disposition of my organs,
tissues, or eyes. By signing below, I indicate that I am emotionally and mentally competent to
make this living will and that I understand its purpose and effect.
__________________________________       ____________________________________
(Date)                                               (Signature of Declarant)
The declarant signed or acknowledged signing this living will in my presence
and based upon my personal observation the declarant appears to be a competent
individual.
__________________________________       ______________________________________
(Witness)
(Witness)
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Session Laws, 2005
Volume 752, Page 956   View pdf image
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