Donor Profile - LSU Health Foundation

Biographical Info for Primary and Spouse

Name*

Title First Name Middle Name Last Name Suffix

Nickname

Maiden Name

Gender

Birthday

Email*

Enter Email Confirm Email

Preferred Phone*

Phone Number*

Spouse Name

Prefix First Middle Last Suffix

Spouse Email

Are you an alumnus? If yes, which school?

Spouse Gender

I graduated from LSU Health New Orleans School of:

Degree:

Class of:

Major / Concentration

I completed a Residency at LSU Health in:

Class of:

My philanthropic interests include:

LSU Health New Orleans School of:

LSU Health New Orleans Department of:

Fundraising Event(s)

Research in:

Do you have family ties to a LSU Health New Orleans School?

Name:	Relationship:	LSU Health School:	Gender:	Birthday:

Are you a current or former faculty/staff member?

Your Name

Title First Name Middle Name Last Name Suffix

School or Department

Planned Giving Options

Please contact me to discuss how to optimize my giving through an estate, life insurance, or IRA rollover gift
I have already included LSU Health Foundation in my estate plans