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New registration, change
or removal of details
Contents
8 Postal address
Important information
What is organ and/or tissue donation?
1
Complete this form to register, change or remove details from
the Australian Organ Donor Register (the Donor Register).
Why is organ and/or tissue donation important?
1
Assistance
Why do people need transplants?
1
Who can become a donor?
1
If you need assistance completing this form call 1800 777 203
(call charges may apply). For more information about the
Donor Register go to www.medicareaustralia.gov.au/organ
Which organs and/or tissue can be donated?
2
Lodgement
How does the organ and/or tissue donation
process work?
2
How are organs and/or tissue removed?
3
This form can be lodged:
s at your local Medicare office
s by folding and posting
s or by fax to: 03 6281 0556
How are organs and/or tissue allocated?
3
When can organ and/or tissue donation occur?
3
4
What is the Donor Register?
4
Who can register on the Donor Register?
5
What if I’m already registered somewhere else?
5
How do I register on the Donor Register?
5
How do I change my registration details?
5
Why do I need my Medicare card number?
6
Organ and tissue donation
11 I wish to register my consent to donate the following
–
organs and/or tissues for transplantation, in the event of
my death. Tick ‘All’ or as many as apply:
Bone tissue
Eye tissue
Heart
All
Heart valves
Kidneys
Liver
Lungs
Pancreas
Skin tissue
–
3 Would other members of your family like to register?
No
Yes
7
Discuss your decision with family and friends
8
Who needs to know my donation decision?
8
How can I start the discussion?
8
We will send you another form allowing up to two
people who live at the same address to register.
What should I discuss?
9
Ref no.
If the medicare number is not known/available
I authorise Medicare Australia to link the below
details to my Medicare record
Applicant’s details
5 Mr
Mrs
Family name
Miss
Ms
DonateLife contacts
11
6 Date of birth
7 Your sex
/
Male
Australian Organ Donor Register.
s I give permission for the details I have provided to be
actioned on the Donor Register
s I have discussed this decision with my family, partner
or friend
s I am aware that I can change these details at any time.
Signature
Date
/
/
Privacy note
Given name
11
Declaration
12 Please register me, change or remove my details on the
Other
10
Where can I find more information about
organ and/or tissue donation?
No
Medicare Australia records will be updated to
reflect this.
Yes
10 Daytime phone number
(
)
@
register on the Donor Register
change my details on the Donor Register
remove me from the Donor Register
register my decision not to be a donor
2 Donor registration number (if known)
R
9 Is this your permanent postal address?
Email
4 Medicare card number
Where can I find more information about the
Donor Register?
What is DonateLife?
Postcode
Registration details
1 I want to (tick one box only):
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Decide and register your decision
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1
Discover the facts
/
Female
The information provided on this form will be used to register
you on the Australian Organ Donor Register or to update
your details on the register. The collection of this information
is authorised by the Medicare Australia Act 1973. This
information may be disclosed to authorised personnel in the
organ and tissue donation network or where authorised or
required by law.
1397.15.06.10—CODE B
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Which organs and/or tissue can be donated?
Individuals can decide to donate specific organs and/or
tissue. Donors have complete choice over which
organs and/or tissue they wish to donate. Donation
can involve:
• organs—including kidneys, heart, lungs, liver and
pancreas
• tissue—including heart valves, bone tissue, skin,
eye and pancreas tissue.
How does the organ and/or tissue donation
process work?
When a person dies in a situation where they can
become an organ and/or tissue donor, the intensive
care medical team raises the possibility of donation
with the family.
The Australian Organ Donor Register is checked. If the
deceased person registered their objection, donation
will not proceed. If the deceased person registered
their consent or had not registered, a DonateLife
coordinator will meet the family to talk about donation.
The family of a potential donor is given time to discuss
and finalise the decision of whether donation will occur.
If donation is agreed to, documentation will confirm
the donation and which organs and/or tissue are being
donated.
All hospitals have a quality control process whereby a
designated officer not involved in the clinical process
must give authority for donation to proceed following
family consent. This part of the process may also
involve the state coroner if the circumstances of the
person’s death are to be investigated by the coroner.
After the organs and/or tissue have been donated, the
DonateLife coordinator keeps in touch with the donor’s
family about the progress of the transplant(s) and
provides support for them during their time of grief.
All donations and transplants are performed by
specialised medical teams in the Australian public and
private health systems.
2
Less than one per cent of all people who die in hospital
each year die in this way.
People can be confused about the difference between
brain death and being in a coma. A patient in a coma is
unconscious because their brain is injured in some way,
however their brain continues to function and may heal.
With brain death, there is no possibility whatsoever that
the brain will recover. Medical tests clearly distinguish
between brain death and being in a coma.
Organ donation may also be possible after a person’s
heart has stopped beating, referred to as ‘cardiac death’,
but this is less common.
Tissue donation
A far greater number of people have the opportunity to
donate tissue for transplantation.
Tissue donation doesn’t require the donor’s death to have
occurred under the same limited circumstances as organ
donation for transplantation to be successful.
Unlike organs, tissue may be stored for a period of time.
Decide and register your
decision
What is the Donor Register?
The Australian Organ Donor Register (the Donor Register)
is the official national register for people to record their
decision about becoming an organ and/or tissue donor
for transplantation after death.
The Donor Register ensures a person’s donation decision
can be verified 24 hours a day, seven days a week by
authorised medical personnel anywhere in Australia.
In the event of a person’s death, information about their
donation decision may be accessed from the Donor
Register by authorised medical personnel and provided
to their family. For more information, see How does the
organ and/or tissue donation process work? on page 2.
4
Why do I need my Medicare card number?
While it’s not compulsory to supply your Medicare card
number to the Donor Register, doing so will enable
your details to be kept up-to-date over time and may
be used to access your most recent name and address
details as held by Medicare Australia.
Greg is a DonateLife Acting State Medical Director.
Sam is a DonateLife Network Hospital Staff Specialist.
6
Discuss your decision with
family and friends
Who needs to know my donation decision?
The people close to you—your next of kin—need
to know your donation decision today. In the event
of your death, they will be asked to confirm your
donation wishes. In Australia, family consent is always
sought before donation can proceed—even if you are
registered on the Donor Register.
The most important thing that helps a family’s decision
is knowing the wishes of their loved one. Families
that have discussed and know each other’s donation
decisions are much more likely to uphold those
decisions.
How can I start the discussion?
Try to use everyday situations to start a discussion
about important life issues, including what to do with
your organs and/or tissue in the event of your death.
A practical guide to assist families in having an
informed and memorable family discussion about
organ and/or tissue donation is available from
www.donatelife.gov.au then Discuss > Discuss
with your family
Some suggested situations to discuss your donation
decision with your family could include:
• the next time your family sits down together for a
meal
• leaving home for the first time as a young adult
• obtaining or renewing your driver’s licence
• celebrating an anniversary with your partner
• having a significant birthday: 18, 21, 30, 40, 50 or
older
8
What is DonateLife?
DonateLife is a network of doctors, nurses, organ
donor coordinators, family support workers and
other professional staff funded and led by the
Organ and Tissue Authority. This network is responsible
for identifying potential organ and/or tissue donors
in Australian hospitals, providing information and
support to families to inform their donation decision,
and providing the clinical service to the community of
facilitating donation and liaising with transplantation
programs.
On 2 July 2008, the Australian Government announced
a new national reform package—A World’s Best
Practice Approach to Organ and Tissue Donation
for Transplantation—to achieve a significant and
lasting increase in the number of life-saving and
life-transforming transplants for all Australians.
The Organ and Tissue Authority is leading the states,
territories, clinicians, consumers and the community in a
nationally coordinated approach to organ and/or tissue
donation for transplantation.
The DonateLife Network is present in every state
and territory across Australia, comprising DonateLife
agencies as well as hospital-based staff dedicated to
organ and/or tissue donation.
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