Make a Donation!

Please make a tax-deductible contribution of a minimum of $1,000 by visiting our  Donation Page Here!

Or print out and mail in the following form:

I wish to support Physicians’ Impact Fund with a gift or pledge in the following amount:
 

___$10,000  ___$5,000  ___$2,500  ___$1,000   Other:_______

I wish to make my pledge payments in the following manner:

___I will pay by a check made out to Physicians’ Impact Fund

___Please charge my pledge to my Credit Card:

___Visa         ___MasterCard         ___American Express    

Name on Card: ___________________________________

Card No.: ________________________________________

Expiration Date: _________Card Verification Code: ____

Novant Health employees may choose from the following options to fulfill their pledge:

Employee ID#_________Dept. Name:______ Dept. ID#__________

____I would like to donate____PTO hours to Physicians’ Impact Fund

____I would like to make my donation using payroll deduction by:

____I am making a one-time donation of $_____ from my pay.

____ I am deducting $______from each pay period for a total number of
____pay periods to complete my pledge as listed above.

_____Please consider this to be a part of Novant Health’s Employee Giving Campaign.

Donor Information:

Name:  _________________________________________ (please print)

Address:  _______________________________________

City: _________________State: ______ Zip: __________

Phone: _________________     Email: _________________

Signature:  _________________________________________

Thank you for making your tax-deductible contribution to the Physicians’ Impact Fund. Please return your completed pledge form to: Physicians’ Impact Fund, P.O. Box 33549, Charlotte, NC 28233. Or donate online at physiciansimpactfund.org

Vision

Our vision is to strengthen the health of our region through comprehensive health initiatives for the underserved. 
Through the power of collective giving and shared resources, members of the Physicians’ Impact Fund have the ability to make a big impact in the greater Charlotte area by awarding grants to strengthen organizations that seek to improve the health of our community. We are particularly interested in supporting opportunities that show promise for long-term gain, and value projects and programs that increase organizational quality, effectiveness and sustainability.