The Dartmouth Institute for Health Policy and Clinical Practice

Thank you for your gift. Your generosity supports the education of future healthcare leaders and fuels the influential work of top scholars addressing the problems of access, equity, cost, and quality in healthcare.

Donation information

Amount:

Designation:

Fund for The Dartmouth Institute

Additional information

Corporate:

This donation is on behalf of a company

Anonymous:

I prefer to make this donation anonymously

Mailing address if different than billing address:

Billing information

Title:

First name:

Last name:

Country:

Street address or P.O. box:

City:

State:

ZIP:

Phone:

Email:

Payment information

All donations are tax deductible to the fullest extent allowable by law. Fundraising for the Geisel School of Medicine is conducted by Dartmouth College, a 501(c)3 recognized charity by the IRS (EIN#02-0222111)

Cardholder’s name:

Credit card number:

Card type:

Card expiration:

Card security code:

Memorial and honorary gifts

Is your gift in memory of or in honor of someone? If so, please complete this section.

Type:

Full name of honoree:

Mail a notification letter on my behalf

Matching Gifts: If your employer will match your gift, please submit the matching gift form to Medical & Healthcare Advancement, One Medical Center Drive, HB 7070, Lebanon, NH 03756

Recurring Monthly Gifts: If you would like to pledge a recurring monthly gift, please call Medical & Healthcare Advancement at (603) 653-0700 or email DH-Geisel.Gift.Recording@hitchcock.org

Prefer to send a check?

Visit our website for our mailing address and instructions for how to make out your check.

Need help?

Do you have a question or need help making your gift? Please call us at 603-653-0700. We’re happy to help!