Project X-Ray Campaign

Community initiative to acquire and replace new equipment for the Radiology department.

  1. Donor Information

  2. Donation Information

  3. Payment Information

  4. $0.00
  5. 3-digit value located on back
  6. Miscellaneous

  7. Confidentiality

    I understand that West Lincoln Memorial Hospital Foundation Inc. will keep my donation information I provided here confidential and agree that the Foundation may forward information or requests for donations in the future.