Thank you for considering brain donation and for planning in advance!
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 this 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 complete arrangements for a donation. In most geographies, 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 death is imminent (hours or days away), or your loved one has already died, please complete the Immediate Need Form.
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.