Please fill out the form below :


    Contact information:

    Donation Item Information – please include all pertinent information of the item(s) being donated.

    Donated Item:

    Item description:

    Fair Market Value of donation item:

    Please print your name exactly how you wish it to appear in all recognition materials, if applicable:

    YES, I/we would like to donate a gift-in-kind. I/we understand that my/our gift will benefit Jay’s Hope at Advocate Health Care

    You will receive an official tax receipt letter from the Advocate Charitable Foundation after this completed form is submitted and processed. For questions, please contact Megan Fergus at 630.929.6909. Tax ID #36-3297360

    Please submit your item/s to:
    Ivette Medina
    Advocate Health Care
    3075 Highland Parkway, Suite 600
    Downers Grove, IL 60515