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Get University of Toledo Authorization Form for Anatomical Donation

D to my survivors. Use of Recognizable Likeness In the development of educational media products, The University of Toledo, College of Medicine MAY make use of my recognizable likeness. If I answer “YES” to Permanent Anatomical Model (above), the “YES” box for “Use of Recognizable Likeness” must also be checked. ANATOMICAL DONATION PROGRAM AUTHORIZATION FORM FOR ANATOMICAL DONATION SIGNATURES DONOR Date Social Security Number Donor’s Legal Signature Date of Birth Telephone .

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