LivingWell Medical Clinic, make a donation

Make a Donation to LivingWell

LivingWell Medical Clinic is a community non-profit, 501 (c)(3) tax-exempt organization. For a brief description of our funding, please click here.

Security Note

If mailing a check, you do not need to fill out this form. Simply mail your check to our address shown at the left of this page. We thank you in advance!


First name:
Last name:
Email address:
Phone number:
Address:
City:
State:
Zip Code:
Country:
What would you like to donate?:
Payment Method:
Credit Card Number (ex.1234-5678-1234-5678):
Expiratioin:
Donation Amount:
If name on card is different, please provide:
Billing address for credit card if different from above:
Comments:

SECURITY NOTE: This submission form is being transmitted over a secure encrypted server connection (SSL). We use the same 128-bit encryption used by the IRS and the world banking institutions. Your credit card information is safe during transmission, and is stored on a secure server for our retrieval. This order may take up to 60 seconds to encrypt and transmit. DO NOT press the "Submit Order" button more than once, as we will then receive duplicate orders. When the order is processed you will see a confirmation screen. If you do not see that screen, please contact LivingWell by e-mail or you may call the office at (530) 272-6800 to check on the status of your donation.