University at Buffalo
School of Medicine and Biomedical Sciences
Department of Pathology and Anatomical Sciences
Anatomical Gift Program
225 Farber Hall, Rm.. 225
3435 Main Street
Buffalo, NY 14214-3000
Telephone: 829-2913 Fax: 716-829-2915
EMERGENCY CONTACT INFORMATION
So that we may include the proper information on
your new wallet card, please complete the
following Donor and Emergency
Contact information and return with the
Declaration of Consent form to the address shown
above.
Please notify our office if this information
changes so that we may send you an updated wallet
card.
