Empowering every adolescent to be healthy, safe and successful
 

PATIENT ASSISTANCE FUND

Donations to the Patient Assistance Fund are used exclusively for Teen Health Connection 
patients. This fund has been used, on a case by case basis, to pay for prescriptions, bus passes, office visits, and individual medical supplies.  
 
Your compassionate support is truly appreciated.
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Donation Information
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Complete the following fields if this gift is a tribute. (optional)  
  Type of Tribute 
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  Title 
  First Name 
  Last Name 
  Address 
  Address 2 
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Contact Information
* First Name 
* Last Name 
* Address 
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Credit Card Information
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Click here for CVV2 information  
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  Same As Above 
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Privacy Policy
We keep your personal information private and secure. When you make a payment through our site, you provide your name, contact information, payment information, and additional information related to your transaction. We use this information to process your payment and to ensure your payment is correctly credited to your account.
 
Annual Statements
Teen Health Connection will issue an annual statement to any donor who makes more than one gift to the organization or any of its initiatives over the course of a calendar year. These statements will be issued annually in January
 
 
Questions? Contact us: 704-381-TEEN (8336) 
 
 

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