Southlake Regional Health Centre Foundation

Thank you for your generous gift in memory of a loved one.

Thank you for making a special gift today in memory of someone special. Your gift will help ensure that your family, friends and neighbours have access to leading edge care, close to home.

Please complete the form below to make your tax-deductible donation now.

You can also ensure that your memorial gift is notified of your generosity. In the form below, you may choose to send an eCard, or to have Southlake Health Foundation mail a card on your behalf.

Are you looking to make a corporate donation? If so, click here.

If you have any questions about your gift, please contact Southlake Foundation at 905-836-7333 or foundation@southlake.ca.

By selecting this option, your gift will remain anonymous to the honouree and their family

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Field Is Required Gift Designation:

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*Please Note: If you selected ‘other’ rather than one of the Hospital’s identified priorities we may need to contact you to ensure that your donation can be put to work as quickly as possible in the area of the hospital you wish to support.

Honouree Information

Tribute Card Type

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eCard

Paper Card

Honour Gift Type:

Honouree Title:

Honouree First Name:

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Paper Card Recipient Information

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eCard Recipient Information

Sending an eCard is a great way to tell family and friends about this gift. Once your gift is processed, your eCard will be sent on the date you select below.

Yes, I would like to send an eCard.

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Yes, send me a copy of the eCard.

Billing Information

Title:

First Name:

Last Name:

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City:

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Donor Phone Number:

Email Address:

Yes, I would like to make this donation anonymously.

I am proud to be part of the Southlake Family as a physician, staff or volunteer

Southlake Foundation is dependent upon the generous support of donors and volunteers to fulfill its mission. We collect your personal information to process your donation, issue a tax receipt, and to demonstrate the impact of your gift at work. Your personal information will not be sold or traded with other organizations. For more information about our privacy practices, view our Privacy Policy or contact us at Foundation@southlake.ca

Yes, I would like to receive occasional email updates from Southlake Regional Health Centre Foundation. To opt-out of receiving these communications, please uncheck the box

Yes, I would like to receive physical communication from this organization.