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
CHANGE OF NAME / ADDRESS REQUEST FORM
To change your name and/or address, please complete
the information below and return to the address of Fax
number above.
