Donation Form

How your gift helps

There are many ways in which you can help Mercy Hospice & Palliative Care continue to provide services to your community. Contributions are just one way. Your support will help us provide charitable care, community outreach programs, children’s programs and grief support camps, palliative care, and respite programs to those in need. (100% of your donation is used to help the patients, children, and families under our care.)

This Gift is from:

First Name: Last Name: Telephone: Email Address:

Mailing Address: Address Line 2: City:

State:

Zip:

(Your information is confidential and will not be shared or sold by Mercy Hospice & Palliative Care)

Please Choose from the following giving options:

One-Time, Memorial and Honorary Gifts:

Many people find great satisfaction in making a gift in memory or in honor of a friend, loved one, or even a special Mercy Hospice staff member, such as a nurse or chaplain.

Simply provide us with the name and address of those you would like notified and we will send them a card letting them know that you made a contribution. The amount of the gift is not disclosed, just the donor’s name.

Special Occasion Gifts or Holiday Honorariums

A special occasion (such as a holiday, birthday or anniversary) is also a great way to let someone know that you are thinking of them on their special day. Let us know the recipient's name, mailing address, and the date and occasion in which you want to celebrate. Mercy Hospice will send her/him an appropriate card for the occasion, informing the recipient that a donation has been made in their honor. The amount of the donation is never revealed and you will receive a card of acknowledgment. Please provide enough advance notice for the occasion to ensure that your card will reach the recipient in time.

Monthly Gift of Remembrance Program:

Many people find it more convenient and affordable to divide their gift into several months. PayPal offers the option to pledge a monthly amount using their "recurring payment option". You automatically become a "Guardian Angel" with a minimum annual donation of $250.

Become an Angel of Mercy:

We invite you to help build a legacy of care and compassion by earning your wings and becoming an "Angel of Mercy".

You have the benefit of knowing you are helping to make a profound impact on the lives of the those that we care for each and every day. Many of our patients are uninsured or underinsured. Many patients have endured snow-balling, staggering medical bills for years. Often, the caregiver and the family have been depleted of their savings, assets, and in some cases, their jobs while caring for the patient.