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Wisconsin Alzheimer's Institute Legacy Society UNIVERSITY OF WISCONSIN FOUNDATION Your Legacy. Their Future. STATEMENT OF DEFERRED GIFT PROVISION Name’s): Address: Phone: Email: As an indication

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How to fill out wisconsin alzheimers institute legacy

How to fill out Wisconsin Alzheimer's Institute Legacy:

01

Gather necessary information: Before starting to fill out the Wisconsin Alzheimer's Institute Legacy form, you will need to gather all relevant information. This may include personal details of the individual affected by Alzheimer's, such as their full name, date of birth, social security number, and contact information. Additionally, you may need to collect financial and medical information related to the individual's condition.

02

Read the instructions: It is essential to carefully read the instructions provided with the form. Understanding the guidelines will ensure that you accurately fill out the Wisconsin Alzheimer's Institute Legacy form and provide all the required information.

03

Complete personal information section: Start by filling out the personal information section of the form. Provide the individual's full name, address, phone number, and date of birth. These details will help identify the person for whom the legacy is being established.

04

Provide medical history: In this section, you will need to provide relevant medical history related to the individual's Alzheimer's condition. Include any diagnoses, treatments, and medications prescribed. This information will assist in determining the level of care needed and opportunities for research or clinical trials.

05

Document financial details: The Wisconsin Alzheimer's Institute Legacy form may require information about the individual's financial situation. This could include income sources, assets, insurance coverage, and long-term care plans, if applicable. Ensure accuracy when providing financial data, as it may impact the provision of support and resources.

06

Consider future plans: The form may include sections where you can outline specific wishes or instructions for the future regarding the individual's Alzheimer's care or research participation. Take time to carefully consider and document any relevant preferences or intentions.

Who needs Wisconsin Alzheimer's Institute Legacy?

01

Individuals diagnosed with Alzheimer's: The Wisconsin Alzheimer's Institute Legacy form is primarily intended for individuals who have been diagnosed with Alzheimer's or other forms of dementia. It offers opportunities for research participation, financial planning, and access to support services.

02

Family members or caregivers: Family members or caregivers of individuals with Alzheimer's may also need to fill out the Wisconsin Alzheimer's Institute Legacy form. It allows them to provide essential information about the affected individual and effectively participate in decision-making processes concerning research, care, and financial considerations.

03

Professionals and researchers: Professionals in the field of Alzheimer's disease research, healthcare providers, and researchers may require the completion of Wisconsin Alzheimer's Institute Legacy forms to collect accurate and detailed information. This facilitates their work in providing resources and conducting studies related to Alzheimer's disease.

Overall, the Wisconsin Alzheimer's Institute Legacy form serves as a valuable tool for individuals with Alzheimer's, their families, caregivers, and professionals by ensuring efficient communication, access to resources, and opportunities to contribute to research and advancement in Alzheimer's care.

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