The Open Door Clinic, Inc.

The Open Door Clinic

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Donation Form

Join The Open Door Clinic, Inc. in its efforts to alleviate the effects of poverty in our communities. With your support, we can make a difference in the lives of many Chippewa County families and individuals who are unable to afford basic health care services. At the Open Door Clinic our volunteers work hard to make certain your donations are used wisely. Wondering how your donated dollars are spent? Here are some examples:

  • A flu shot-$9
  • 3 months of a cholesterol-lowering medicine-$5.93
  • Treating a strep throat-$6.82
  • 100 days of thyroid medicine-$12.61
  • An asthma inhaler-$41.37
  • Emergency kit for bee stings-$231.18
  • On a typical clinic night two dozen medical and non-medical volunteers help about 45 patients.

I want to help!

Yes _____

 

I would like to make a tax-deductible contribution to The Open Door Clinic, Inc.

My gift of $ __________ is enclosed.

Name:

_________________________________

Organization:

_________________________________

Address:

_________________________________

City:

_________________________________

State/Zip:

_________________________________

Home Phone:

(_____) __________________________

Work Phone:

(_____) __________________________

Fax:

(_____) __________________________

E-mail:

_________________________________


Thank you for your support!

 

Privacy Policy: You can feel confident about how we use the information you give us. The Open Door Clinic, Inc. does not rent, sell, or share personal information about you with other people or companies without your prior consent.