HealthPartners' #HealthChampionsCan

Your donation counts

As a Health Champion your gift directly supports healthy charity work during this crisis and beyond.

Please provide your contact and payment information. The contact information is required to generate a tax receipt. The electronic tax receipt will be sent to the email address that you provide.

* Denotes required information.

Make a personal donation:
Make a donation on behalf of an organization:

Connecting to Facebook, please wait...

* First Name:
* Last Name:

Contact Information


	Home Work

Enter address manually
* Address:

* City/Town:
* Country:
* * * * Province/State:
* Postal/Zip Code:
Phone Number:	( ) Ext.
Cell Phone Number:	( )
* Email Address:
Your support matters to us, so HealthPartners would like to use your information to keep in touch about things that may matter to you. If you choose to hear from HealthPartners, we may contact you in the future about our ongoing efforts.
Allow HealthPartners to contact me by email.

Donation Designation

I choose to support a healthier Canada where my gift to HealthPartners will benefit all 16 member health charities.

HealthPartners

I choose to designate my gift to one or more of HealthPartners member health charities. If I choose more than one charity, my donation will be divided equally.

ALS Canada
Canadian Cancer Society
Arthritis Society
Parkinson Canada
The Lung Association
Canadian Hemophilia Society
Muscular Dystrophy Canada
Kidney Foundation
Crohn’s and Colitis Canada
Cystic Fibrosis Canada
Canadian Liver Foundation
Huntington Society of Canada
Diabetes Canada
Heart & Stroke
Alzheimer Society
Multiple Sclerosis Society of Canada

Payment Information

Pay using Credit Card
Card Security Number is not supported in data entry. To process a credit card payment, you need to disable Card Security from the Electronic Payment page in the Configuration tab.
Payment Method:	One Time Payment Credit Card
* * Donation Amount:	$25.00 $50.00 $100.00 $250.00 Other
Did you know that by covering the processing fee, HealthPartners will be able to help more people?
I want to cover the fees for my donation ( %ProcessingFee% ).

* Processing Date:
	installments
Pay using PayPal
* Credit Card Type:
* Credit Card Number:
* Card Security Number:	Where is my Card Security Number?
* Cardholder's Name:
* Credit Card Expiration:



* Bank Name:
* Bank ID:
* Cheque Number:
* Transit number:
* Account Number:

Your privacy is important to us, so HealthPartners will keep your personal data secure and HealthPartners will not use it for marketing communications which you have not agreed to receive. At any time, you may withdraw consent by emailing info@healthpartners.ca or by contacting our Privacy Officer. Please see our Privacy Policy