Disaster Relief - North Carolina Medical Society

Disaster Relief

Help Get North Carolina Health Care Practices Back on Track after Hurricane Florence

Your tax-deductible donation will support the newly established Disaster Relief Program, administered by the North Carolina Medical Society Foundation and provide grants to rebuild or repair damaged practices.

Donation Amount

$ 500.00

$ 250.00

$ 100.00

$ 50.00

Other

Gift Details

If this gift is being made on behalf of company or if you wish to keep your gift anonymous, please check the appropriate boxes below.

Corporate:

This donation is on behalf of a company

Anonymous:

I prefer to make this donation anonymously

Billing Information

Title:

First name:

Last name:

Country:

Address lines:

City:

State:

ZIP:

Phone:

Email:

Payment Information

PLEASE NOTE: IT MAY TAKE SEVERAL SECONDS FOR YOUR TRANSACTION TO PROCESS; do not click on the donate button more than once. Although it may seem as though your submission has lagged, you should see a confirmation screen momentarily.

Cardholder's Name:

Credit Card Number:

Card Type:

Card Expiration:

Card Security Code:

Matching Gifts

Does your company offer to match donations made by their employees? If so, please let us know by checking the box below and filling in the company name, the appropriate contact with your employer and their phone number.

My company will match my gift

Additional Security

This is a security measure to help prevent fraud.

	The NCMS is a proud partner with Medical Mutual.