about_us location your_hosp_visit volunteers web_nursery contact_us
   

Donations

The Good Samaritan Regional Health Center Foundation welcomes your charitable contribution. Your gifts make possible the exceptional health care services provided every day to our patients. If you would prefer to mail your gift, please print this page and mail your completed form with a check made payable to:

Good Samaritan Regional Health Center Foundation
605 North 12th Street
Mt. Vernon, IL 62864

Please enter the following information if you would like to make a contribution.
Items marked with * are required fields.

Gift Information
$

If selecting anything other than One-Time, charges will continue at this frequency until donor contacts the Good Samaritan Regional Health Center Foundation to cancel or change the donation.


Donor Information
Payment Information
(No Dashes or Spaces)
Comments
Security Code
Type the text shown in the box into the field below. All characters must be entered in UPPERCASE.
  
Powered by eTapestry.com.
location your_hosp_visit volunteers web_nursery contact_us
 
Terms & Conditions | Privacy Policy
Skip Navigation Links.