Withdraw your registration

Use this form to remove your existing registration from the register. This will leave no recorded organ donation decision for you. Fields marked * are mandatory

Cymraeg

About you

Title

First name *

Last name *

Date of birth *

On my GP medical record I am recorded as

We ask for this information in order to retrieve your NHS Number efficiently

Female

Male

Neither matches my GP record

Your address

Enter your postcode and select your address, we will do the rest

Address line 1 *

Address line 2

Town

County

Country

Postcode *

Accept address Cancel

Your contact details

We will only use these details to contact you about your registration if we need to obtain any additional information

Telephone

Mobile

Additional information

This optional information is only used by NHSBT for analysis of the NHS Organ Donor Register and is not stored against your registration

Ethnicity

Religion

Withdraw

Withdrawal reason *

Confirmation

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