Cancel Registry Enrollment

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

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

Or 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.

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.