Palliative & Hospice Care

Thank you for your gift. Your generosity supports programs and services at the Jack Byrne Center for Palliative & Hospice Care that meet the physical, emotional, and spiritual needs of patients with life-limiting illness, and provide support to family members and loved ones.

Is your gift in memory of or in honor of someone? If so, please complete the Memorial and Honorary Gifts section at the bottom of this form.

Donation information

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$ 500.00

$ 250.00

$ 100.00

$ 50.00

Other

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I prefer to make this donation anonymously

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All donations are tax deductible to the fullest extent allowable by law. Fundraising is conducted by Dartmouth-Hitchcock Health (EIN#26-4812335), a 501(c)3 charity recognized by the IRS. Your gift will appear on your credit card statement as a payment to “DHealth Giving.”

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!