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Make a One Time Gift

Every gift helps us provide health and wellness services to our community members regardless of their ability to pay. Since 1964, we have worked to empower our community members to live their healthiest life possible. Thank you for helping us continue our work toward this goal.  

Donation Amount
Select Gift Amount:
Enter numbers only, no symbols.
Donation Info
First Name *
Last Name *
Address Line 1 *
City *
State/Province *
Postal Code *
Please provide your entire address here including Apartment #, Suite # etc.
Fund Designation
Fund Designation: If desired, you may designate your donation to support a specific Northwest Colorado Health program
I would like additional information on including Northwest Colorado Health in my will or estate plans.
Donation Recognition
Tribute Type
Please provide the name of the honoree or deceased and the address for notification of your donation.
Anything else you would like to tell us about this donation.
Credit Card Information
Visa MasterCard American Express Discover

Visa®, MasterCard® & Discover® cardholders
Your security code is the 3-digit code at the end of the signature field on your card's back.

American Express® cardholders
Your security code is the 4-digit code located above the actual credit card number on your card's front.

Make this a monthly payment?
Make this a monthly payment?
Cover the fee associated with this online transaction?
Cover the fee associated with this online transaction?
Your total payment will be
Your credit balance will cover
Your credit card will be charged
Your bank account will be charged

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