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Additional(instructions(or(limitations.(
[If'the'space'below'is'not'sufficient,'you'may'attach'additional'pages.''
If'you'do'not'have'any'additional'instructions'or'limitations,'write'“None”'below.]'
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[The' “anatomical' gift”' langu age' provided' below' is' required' by' ORC' §2133.07(C).' Donate' Life'
Ohio'recommends'that'you'indicate'your'authorization'to'be'an'organ,'tissue'or'cornea'donor'at'
the' Ohio' Bureau' of' Motor' Vehicles' when' receiving' a' driver' license' or,' if' you' wish' to' place'
restrictions'on'your'donation,'on'a'Donor'Registry'Enrollment'Form'(attached)'sent'to'the'Ohio'
Bureau'of'Motor'Vehicles.]''
[If'you'use'this'living'will'to'declare'your'authorization,'indicate'the'organs'and/or'tissues'you'
wish'to'donate'and'cross'out'any'purposes'for'which'you'do'not'authorize'your'donation'to'be'
used.'Please'see'the'attached'Donor'Registry'Enrollment'Form'for'help'in'this'regard.''In'all'
cases,'let'your'family'know'your'declared'wishes'for'donation.]