Consent Form | Silent Mentor Program

Kindly click the link below to download and print the Voluntary Body Donation Consent Form (in English). The Mandarin version is for reference only and should not be submitted.

English Form (For Submission)

Voluntary Body Donation Consent Form (English)

Download Form (PDF)

中文版本（仅供参考）

捐献遗体同意书（中文版，仅供参考）

查看表格 (PDF)

Important Notes

2 Trustees and 1 Witness are required to sign the Form together with the Donor.
Trustees and Witness should be assigned from Spouse, Children (aged 18 & above), Siblings and other relatives of Donor in that sequence.
The following should be sent to us via courier service once completed:
a) Consent Form fully signed by Donor, Trustees and Witness.
b) Photocopy of IC of Donor.
Item 3 (a) & (b) should be couriered to the following address:
Silent Mentor Centre, 
Department of Orthopedic Surgery, 
Level 3, Faculty of Medicine, University of Malaya, 
Lembah Pantai, 50603 Kuala Lumpur, Malaysia. 
Tel: (03) 019-282 6608 / 03-7949 4957
An e-Body Donor Card will be issued and posted by Whatsapp service within 2 weeks after receipt of the completed Consent Form.

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