I would like to inform California Pacific Medical Center Foundation of a bequest or other gift:

Please enroll me in the Legacy Society based on the information I provide below.*
OR
Please print this form, complete and mail to: CPMC Foundation, PO Box 7999, S.F., CA 94120-7999. Or call 415-600-2114 for assistance.

 

ENROLLMENT:

I have already included a bequest or other gift in my estate plan through my:

Will    Trust    Insurance policy    Retirement plan    Other

Please list my(our) name(s) in the donor honor roll as:

I would prefer to remain anonymous.
I have a question. Best time to call me:       

Name:

Address:

City: State: Zip:

Telephone:     Email:

Date of Birth:

Today's Date:

*Information on this page is not encrypted. If you are concerned about maintaining your privacy, please call 415-600-2114 or e-mail sanforp@sutterhealth.org to request an enrollment form. Thank you.