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Leave a Legacy

Lifetime Partners — Member Profile

Please fill out the form below to send us your Member Profile, so that we may welcome you into Lifetime Partners.

Please note: All highlighted and starred (*) fields are required.
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Please share with us, in confidence, more about your estate provision for the Physicians Committee. The following information is optional.

I have named the Physicians Committee as a beneficiary of my:

Gifts Anyone Can Make

Gifts That Pay You Income

Gifts That Protect Your Assets

This provision is stated as a:
Based on Percentage:
My gift is: