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Hospital In-Kind Donation Form


Thank you so much for making an in-kind donation (donation of items) to Erlanger or Children’s Hospital at Erlanger! We deeply appreciate your generosity!


In order for us to provide you with an appropriate tax letter, please complete this online form below and submit a photo or two of the items you have donated. The photo can be a collective picture of all of your items as you do not need to provide a picture of each individual item you are dropping off. With this form and your submitted photos, we will be able to generate an appropriate letter to send to you that can be utilized for tax purposes. Should you have any additional questions or concerns, please contact us at foundation@erlanger.org or 423-778-6600.


 

Today's Date 

Contact Information


Donor's Name:  *
Are You the Family of a Patient?  *
Street Address:  *
City:  *
State:  *
Zip Code:  *
Is this your home or business address? 
Cell Phone Number:  *
Email:  *

Please list items, quantities and attach photos individually.


Item #1: 
Quantity 
Attach a photo of Item #1: 

Item #2 

Quantity: 
Attach Photo of Item #2 

Item #3 

Quantity 
Attach photo of Item #3: