Donate

Did you know?

Burgess has two family clinics to meet your healthcare needs located in Mapleton and Sloan, Iowa.

For your convenience, you may use this secure form to make a donation to Burgess Health Center Foundation.

Name*
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Address*
Street Address Address Line 2 City State ZIP Code
Email
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Donation Amount
Donation Designation
- In Memory
- In Honor
- Guardian Angel
- Area of Greatest Need
In memory or honor of whom:
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Honoree Address (Address not needed for Guardian Angel recipient)
Street Address Address Line 2 City State ZIP Code
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Supported Credit Cards: American Express, Discover, MasterCard, Visa
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