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Thank you for your contribution to Partners for Care. Your gift will help support UCLA Health physicians, nurses, and care partners to save, extend, and dramatically improve lives in a safe, private, and dignified manner.

Donations to the general Partners for Care fund support many patient programs, such as the Care Coordination Program, Music at the Med Program, and the Spiritual Care Program. You can also select to give to other specific funds that Partners for Care supports (see dropdown menu below).


Required fields are indicated with an asterisk (*).
Gift Information
*Please direct my gift to the following fund:
*I would like to make:
  Other $
(Contributions of $1000 or more are eligible.)

Donor Information   

Personal
Title:
* First name:
  Middle name:
* Last name:
  Suffix:
   I am making this gift as a proxy for my organization/company, which should be recognized as the legal donor
UCLA graduation year(s):

Spouse/Partner
  Name:  
  UCLA graduation year(s):

Joint Gift
* This is a joint gift with
my spouse/partner:

Contact Information
* Street:
 
U.S. Addresses  
*   City, State, Zip:
Non-U.S. Addresses  
  Non-U.S. City/County
  or Province/Postal Code:
  Country:
* This address is my:
* Home telephone:
Business telephone:

* E-mail address:
* This e-mail is my:

Gift Options
Matching Gift

  My/my spouse's employer will match my gift.
  Company name for matching gifts:
  This company is:
Tribute Gift
Please check this box if you would like to honor a family member, faculty member, business associate, community leader, or other with your contribution.
If your gift is in recognition of a STAR employee, please also check the box in the "Additional Information" section at the bottom of this page.
 
Payment
Payment method:
Additional Information
I am interested in learning more about how I can include UCLA in my estate plan.
This gift is anonymous.
I am interested in learning more about Partners For Care.
 
One of the ways we express our gratitude is by listing our donors' names in UCLA honor rolls. If you wish to exclude your name, please check this box.
Please click here if your Tribute Gift is in recognition of a STAR employee.
Please click here if you are a current UCLA employee.

 
Comments: 

     



If you have any questions about this donation, please contact Noah Green, Assistant Director of Development, Patient Care Programs, at 424-325-8184 or nlgreen@mednet.ucla.edu.
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