Donation Your Body

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Forensic Anthropology Center, University of Tennessee, Knoxville

Body Donation Document

I, __________________________________, do hereby dispose of and give my


(donor’s name)
body, after my death, to The University of Tennessee, Knoxville, for use by the
Department of Anthropology or its designee, for educational and research purposes. I
request, authorize, and instruct my surviving spouse, next-of-kin, executor or the
physician who certifies my death to notify The University of Tennessee, Department of
Anthropology (telephone: (865) 974-4408), immediately after my death of the
availability of my body.

Witness my hand and seal this _____ day of _________________, _____,


(day) (month) (year)
at ______.
(time)

________________________________
Donor’s Signature
________________________________
________________________________
Address

On this _____ day of _____________, _______, signed this Body Donation Document in
(day) (month) (year)
our presence and we, as attesting witnesses, at the request of the Testator and in his/her
presence and in the presence of each other have also signed this document.

WITNESSES:

Name: ______________________ ________________________


(Print Name) (Signature)

Address: ___________________________________
___________________________________
___________________________________

Name: ______________________ ________________________


(Print Name) (Signature)

Address: ___________________________________
___________________________________
___________________________________

Version 2: 1/26/2008. Downloaded from web

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