Eye Donation Consent Form

DRISHTI

Let Someone See | Give the Gift of Vision

"I am proud to pledge my eyes so that someone else may see the beauty of this world."

— Join Nandagovindam's Eye Donation Campaign

Why Eye Donation Matters

Every year, millions of people suffer from corneal blindness — a condition that can be cured through a simple corneal transplant. When you pledge to donate your eyes after death, you give someone the priceless gift of sight. One donor can restore vision for TWO people.

Key Facts:

□  Eyes can be donated only after death (within 6 hours).

□  Age, gender, and blood group do NOT matter for eye donation.

□  Eye donation does NOT disfigure the face or delay funeral rites.

□  One pair of donated eyes can give sight to TWO corneal blind patients.

□  Anyone can be an eye donor — including spectacle or contact lens wearers.

Donor Pledge Details

Emergency / Next of Kin Contact

Consent & Declaration

I, the undersigned, hereby voluntarily and willingly pledge to donate my eyes after my death for the purpose of corneal transplantation to restore sight to the visually impaired. I make this pledge of my own free will, with full awareness of its implications.

I confirm that:

Initiated by Nandagovindam — Eye Donation Awareness Campaign

"Your eyes can light up someone else's world.  Be a hero. Pledge today."

Please share this form with your family and friends. Together, let us spread the gift of vision.