AUTHORIZATION FOR RELEASE AND DISCLOSURE OF INFORMATION
I, or my authorized representative, authorize the American Transplant Foundation and its volunteers to contact me via email or phone to provide information about living organ donation and access to publicly available profiles of transplant candidates seeking donors.
I understand that:
1. This authorization is voluntary.
2. I have the right to revoke this authorization at any time in writing, except to the extent that action has already been taken based on this authorization.
3. Communications may be electronic, such as email, and such methods may not always be secure. There is no guarantee, assurance, or warranty of confidentiality.
4. I agree to hold the American Transplant Foundation and its officers, directors, employees, and volunteers harmless from any claims or liabilities that may result from the electronic communications or my participation in ATF programs.
5. ATF provides education and information about living donation but does not provide medical advice, directly match donors with recipients, or coordinate medical procedures. I am responsible for making my own informed decisions about living donation in consultation with qualified medical professionals. |
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