Support Good Samaritan Hospital Medical Center

   
Please join us in Honoring Our Community's Health Care Heroes
with a gift that supports their very important work now more than ever! Your gift will support Good Samaritan Hospital Medical Center's Emergency Services, including the new, dedicated Pediatric Emergency Department, and will help the facility in its efforts to remain on the cutting edge of emergency medicine and ready to respond to any crisis.

 
Donation Information
$ 500.00
$ 250.00
$ 100.00
$ 50.00
$    
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  Note: The Card Security Code is not required for Maestro, Switch and Solo cards.
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Questions? Contact Ashley King at 631-376-3097 or Ashley.King@chsli.org. 
To make a gift by mail, use our printer-friendly version of this form and send it with your check to:

Good Samaritan Hospital Foundation
1000 Montauk Hwy.
West Islip, NY 11795
Please make checks payable to the Good Samaritan Hospital Foundation.