Make a Donation

Did you know?

Burgess has a family pharmacy in Whiting and offers FREE local delivery.

For your convenience, you may use this secure form to make a donation to the Burgess Health Center Foundation.

Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Email
Daytime Phone
Donation Amount
Donation Designation
- In Memory
- In Honor
- Guardian Angel
- Area of Greatest Need
In memory or honor of whom:
Would you like us to let this person or their family know of this donation?
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- Yes
Honoree Address (Address not needed for Guardian Angel recipient)
Street Address Address Line 2 City State ZIP Code
Note you would like to add regarding donation:
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Supported Credit Cards: American Express, Discover, MasterCard, Visa
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