Search SHS:				Text size:	A	A	A
				Información en español


Newborn photos
Log in to see photos of the new arrivals!


Now accepting new patients
Kimberly James, MD Samaritan Mid-Valley OB/GYN

Foundation Contribution

Each of the hospital foundations within Samaritan Health Services enjoys a tradition of community support. Over the years, gifts to the foundations have helped construct buildings, enhance programs, purchase new medical equipment and fund scholarships for health education and services.Your gift today will help our local hospitals fulfill their health care mission in the community.

To make a contribution, simply follow the instructions outlined below. Thank you for your support!

Fields marked with a red asterisk (*) are required.

Title*

First Name*

Last Name*

Spouse Title

Spouse First Name

Spouse Last Name

Address*

City*

State*

Zip*

Phone

()-
Home Work

E-mail

Total Amount of Contribution*

Desired Contribution Method*

Credit Card	Check
	Instructions for mailing your check contribution will appear on the next page.

For Credit Card Contributions:

Card Type

Card Number

Name as it appears on card

Expiration Date

How would you like your name to appear in publications acknowledging your gift?*

Name

In Memory of...

Notificant Information:
Name
Address
City, State & Zip

Please list my gift as anonymous

At which Foundation would you like your contribution to be used?*

	Albany General Hospital
	Good Samaritan Hospital
	Lebanon Community Hospital
	Samaritan North Lincoln Hospital
	Samaritan Pacific Communities Hospital
	Equally at each hospital

How would you like your gift to be used?*

	Building Healthier Communities Fund (unrestricted - where the need is greatest)
	General Endowment Fund
	Pastega Guest House (GSH only)
	Cancer Care
	Cardiac Care
	Hospice Care (not available at GSH)
	Other (please specify) Please see specific site for listing of other available funds.

	back to top



Home \| Regional Health Services \| SHS Facilities \| Find a Physician \| Health Info + Classes About SHS \| Billing Info \| Quality of Care \| Community Benefit \| Volunteering \| Employment \| Foundations \| Emergency Preparedness © Copyright 1999-2007 Samaritan Health Services \| Send Feedback to SHS \| Patient Privacy Information