Memorial Gifts

If you have chosen to direct memorial contributions to VCU School of Medicine or VCU Health in memory of your loved one, please complete the form below so we know how to inform you about gifts received. Questions? Contact Michelle Holder, stewardship coordinator, at (804) 827-4935 or michelle.holder@vcuhealth.org.

• 1 Contact information

  • Title:  Dr. Miss Mr. Mrs. Ms. Mx. Professor The Reverend The Honorable
  • First name: 
  • Middle initial: 
  • Last name: 
  • Suffix: 
  • Address line 1: 
  • Address line 2: 
  • City: 
  • State:  Virginia Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Washington Wisconsin West Virginia Wyoming Not applicable
  • ZIP/postal code: 
  • Phone: 
  • Email: 
  • Thank you for providing your contact information for VCU to communicate with you in the future.
• 2 Memorial information

  • Gifts are dedicated in memory of: 
  • Memorial gifts are directed to (fund): 
  • Do you prefer to receive commemorative updates via email or mail?
  • Email 
  • Postal mail 
  • Additional comments: 

• Click submit to securely enter your payment information.