Cancel Enrollment

To cancel your enrollment in the Mississippi Donor Registry
please download the Registry Removal form, complete and mail to:

        Mississippi Organ Recovery Agency
        499 Gloster Creek Village
        Suite F1
        Tupelo, MS 38801


e-mail the completed form to

You will receive a letter of confirmation regarding your decision to be removed from the Mississippi Donor Registry in the mail.

                 Download a copy of The Donor Registry Removal Form in PDF format

*Note  -  If you are acting on behalf of someone physically unable to complete and sign the Registry Removal form, please contact our offices at 1-800-690-8878 Monday through Friday between the hours of 8 a.m. to 4:30 p.m. for a third party removal form.



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