Thank you for considering brain donation and for planning in advance!
Brain donation is still possible at this time despite COVID-19.
If death is imminent (hours or days away), or your loved one has already died, please complete the Immediate Need Form.
Coping with neurological decline and end of life are not easy, but making plans in advance is so much easier than waiting until the last-minute when stress is sky-high. Our goal is to make the brain donation proceed smoothly. If you are looking for general information, you’ll find it on the page about the requirements and process for brain donation.
Note that you’ll need to select a funeral home or cremation organization before we can know if brain donation is possible and at what cost. In many major cities, we can suggest a cooperative, cost-effective organization.
Of course, information you provide in this form is confidential and not shared with third parties until you give us the final go-ahead. Fields marked with an asterisk (*) are required fields.
If you have difficulty — for whatever reason — completing this form, please contact us. Alternatives are sending us the answers via email, fax (650-233-9278) , or screen shots. Or, we can take the information by phone during regular business hours if staff is available.
We are honored to assist your family.