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Thank you for supporting the Samaritan Employee Caring Campaign. Please submit the form below to make your pledge. For assistance, please call 844-768-4256.

Please review the fund options listed on the previous page and choose which foundation(s) and fund(s) you would like to support:
To give paid time off (PTO):
To give through payroll deduction:
Signature

If you would like to make your contribution with cash or check, please return it to the Samaritan Foundations office via mail (815 NW Ninth St., Suite 136, Corvallis, OR 97330) or your local foundation office. Employees may also send via interoffice mail to Samaritan Square, Suite 136. Credit card donations can be made at samhealth.org/Giving. Thank you!