New One Heart Member Donation Form

  1. Donation
  2. Step
  3. Review

Donation

Yes, I want to be a member of Doctors Community Hospital’s One HEART program. You have my authorization to make the below tax‐deductible donations withdrawn bi‐weekly by the Payroll Department:
Remember that your contribution is tax-deductible.
Donation:
I would like my contribution to benefit the following
(CHOOSE NO MORE THAN TWO OF THESE DONATION CATEGORIES)
Are you interested in joining the One HEART committee?