Alumni News Submission

If you would like to submit an address change or have news about your family or practice to share with other Northwestern urology alumni, please complete the form below. (Please note that this form is only for alumni of the urology residency program and the information submitted will only reach the urology department. It will not reach the alumni offices of either the Feinberg School of Medicine or the University as a whole.)

Type of Submission«

My address has changed

I would like this information shared with other alumni, faculty and staff via the department newsletter

I would like this information included on the department Web site

First Name«

Middle Initial

Last Name«

Address 1

number and street

Address 2

suite or apartment number

City

State

Zip Code

Country

E-mail Address«

name@domain.com

Telephone Number

please include area code

Graduation Year

Alumni News

Fields marked with "«" are required.