Thank you for completing this ALLFTD brain donation form. This form will permit us to prepare detailed instructions for all parties involved in the brain donation. And it eliminates the slow and error-prone process of transcribing names, numbers, and information over the phone.
Brain Support Network’s next steps are to prepare detailed, email-based instructions for:
- Completing a consent form, and sharing the consent in advance and at the time the brain donation work occurs. The consent paperwork instructions are emailed to the family only. The legal next-of-kin or healthcare power-of-attorney signs the consent. One witness also signs. Generally, paperwork is shared in advance using email or fax with Brain Support Network, the funeral home or cremation organization, and the pathology specialist. And a hard-copy of the paperwork is shared again at the time the brain donation work occurs.
- All parties involved in the brain donation as to tasks to perform just prior to end of life and at the time end of life occurs. Generally, the parties include the family, hospice (if any), a care facility (if any), a funeral home or cremation organization, pathology specialist, and possibly a body donation organization.
- Ordering non-UNC neurological records (if any) and completing a family questionnaire. These instructions are sent to the family only.
Starting with the consent-related instructions, we will be emailing instructions to your family as soon as possible.
If you wish to follow up, contact us. You can also call or text us at +1 650 814-0848. We are generally available seven days a week, 6am to 8pm PT.