Your Donation Matters

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*Note: this form does not currently work with Apple iPhones or iPads. Please use a desktop computer or Android device to donate.

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Suggestions: In memory of, Acknowledging, Presented by
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By checking the "I agree to the Terms and Conditions" checkbox below I am confirming my payment is in accordance with the rules and regulations of the agreement between me and my card issuer.

My payment can only be completed upon the acceptance and authorization of my issuing credit card company. If my payment cannot be completed, I will retain the same liability, which is my sole responsibility, for payment as though I had not attempted to make the payment. Furthermore, I may also be liable for additional fees and penalties to the extent of applicable law.


A receipt can be printed after payment is accepted which will serve as evidence of payment. If you provide an email address during the payment process, a receipt will be emailed to you after the payment is processed.


If for any reason you wish to make a change to the payment after submission, please contact Hutchinson Regional Medical for assistance.