Body Donor Program - Body Donation Inquiry Form - School of Medicine and Public Health

Note: The inquiry form is different from the body donation form. The body donation form is not available online. You must contact the program by phone, email or the inquiry form to request a body donation form.

"*" indicates required fields

Name*

First Last

Email*

Phone*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

I am requesting information:*

For myself

On someone else's behalf

Name

Of the person you are requesting information for.

First Last

Relation to the Potential Donor

I would like to request a registration packet (including the body donation form) at this time.*

Yes

No

Questions

If you have any questions about the program or donation process, list them and our staff will get back to you.

CAPTCHA

Program Contact Information

Email bodydonorprogram@med.wisc.edu

General Information or Donation Packet Request
608-262-2888
Monday through Friday, 8 a.m.–4:30 p.m.

Regarding a Death of a Registered Donor
608-262-2800
At any time of day including evenings, weekend, and holidays

Thank you for your interest in donating!