Grateful Patient Program

To express your appreciation for the care received at West Lincoln Memorial Hospital, donate today.

Your donation will provide funding for West Lincoln Memorial Hospital’s current equipment needs.

If you wish your gift may be made in honour of a physician(s) and/or staff member who contributed to your, or your loved ones, care while at West Lincoln Memorial Hospital. A certificate of appreciation will be sent to the caregiver(s) acknowledged.

Donation Form

Your Information
Name*
First Last
Phone*
Email*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Tribute Option
Name of Caregiver(s)
Department(s)
Message to Caregiver(s)
Miscellaneous
Additional Comments
Consent*
I agree
I understand that Tribute messages will be conveyed to the caregiver(s) through a certificate of appreciation.

Confidentiality

I understand that West Lincoln Memorial Hospital Foundation Inc. will keep my donation information I provided here confidential and agree that the Foundation may forward information or requests for donations in the future.