Gift Information

Donation Amount*
$
Donation Choices*
  • Area of Greatest Need
  • Building the Endowment
  • Equipment
  • Facilities
  • 3-D Mammogram Machine
  • Cardiac Rehab
  • Memorial
  • Nurses Department
  • Physical Therapy

Donor Recognition

The Chase County Hospital Foundation publicly thanks those who support our work.  We also respect the privacy of indivduals who may not wish to have their generosity publically recognized. If this is you please document in the Additional Information box below.  Thank you.

Contact Information

Country*
State / Province*
Address*
City*
*
*
*
*
*
*
Email*
Confirm Email*
Phone*

Payment Information

Amount*
$
Name on Card*
Card Number*

Additional Information

Additional Comments

Security Code