Future Gift Intention Form

 

For our friends who have included Cincinnati Children’s in their estate plans.


Click if you prefer to print
this form and mail.


 

*  


*  


*

(Maximum response 255 characters, approx. 5 rows of text)

*  


*
Question - Required - Date of Birth:




  While we promise to keep the details about your future gift confidential, we would like to include your name as a member of our William Cooper Procter Legacy Society on the Cincinnati Children's Honor Roll.
   


*
Question - Required - I wish to remain anonymous.


   


*
Question - Required - Please describe your planned gift: (Please select all that apply.)

 

(Maximum response 255 characters, approx. 5 rows of text)

 

(Maximum response 255 characters, approx. 5 rows of text)

   


*
Question - Required - Are you willing to share your story for use in a future publication?


  Please be assured that this Future Gift Intention Form does NOT create a legal or binding commitment upon your estate. We would simply like to be able to thank you for your thoughtful planning and to make sure your gift is used as you intended. 
 
If you would like to designate your gift to a specific area of the medical center, please indicate this on the reverse side of this form. THANK YOU!

Although the following information is not required, your answers will greatly assist with Cincinnati Children’s long-range planning. The terms of your gift will remain confidential.

 

(Maximum response 255 characters, approx. 5 rows of text)

 

(Maximum response 255 characters, approx. 5 rows of text)

 

Cincinnati Children’s would like to recognize your attorney and/or other professional advisor(s) who have assisted you in creating your legacy gift. We hope you will take a moment to add name(s) and address(es) below so we can thank them personally at one of our special events held for professional advisors.

   


 

(Maximum response 255 characters, approx. 5 rows of text)

   


   


 

Questions may be directed to:

Suzanne M. Rohlfs, JD, CAP®
Director, Legacy Planning
Telephone: 513-636-1192
Email: suzanne.rohlfs@cchmc.org 

Kelli M. Kurtz, CAP®
Senior Officer, Legacy Planning
Telephone: 513-636-5685
Email: kelli.kurtz@cchmc.org

Learn more about legacy giving at cincinnatichildrens.org/legacyplanning

   Please leave this field empty