Recognize your Guardian Angel

Did a caregiver or other staff member make a difference during your time at The Ottawa Hospital? You can recognize them as your Guardian Angel by making a donation today to help The Ottawa Hospital purchase new equipment and build modern facilities. Your Guardian Angel will receive acknowledgement of your gratitude as well as a unique lapel pin to proudly wear throughout the Hospital.

Please provide your contact and payment information. The contact information is required to generate a tax receipt. The electronic tax receipt will be sent to the email address that you provide.

Gift Information

Field Is Required Donation Amount

$500

$200

$100

$50

Other

Enter amount

Field Is Required Please direct my gift to:

Use my gift where it is needed most.

Direct my gift to:

Other

What inspired you to donate:

Tribute Information

Name of Guardian Angel (Please provide first and last name if known):

Occupation (e.g. Nurse, Orderly):

Department (e.g. Neurology, Oncology):

Campus

Send a message to your Guardian Angel (max of 255 characters):

Please advise the Foundation if you wish to keep your name and reasons for honouring your Angel confidential.

Yes, I wish to remain anonymous to my Guardian Angel.

Donor Information

I would like to make this gift on behalf of an organization/company (if this is a personal gift, do not check this box).

Organization Name:

Donor Title:

Donor First Name:

Donor Last Name:

Donor Address:

Donor Address 2:

Donor City:

Donor Province/State:

Donor Postal/ZIP code (A1A1A1, no spaces):

Donor Country:

Donor Phone Number:

Email Address:

I allow The Ottawa Hospital Foundation to contact me by email

Occupation:

I am an employee of The Ottawa Hospital

Cardholder Information

Please make sure your billing address is exactly as it appears on your credit card statement.

Use donor information as billing information.

Cardholder Title:

Cardholder First Name:

Cardholder Last Name:

Cardholder Address:

Cardholder Address 2:

Cardholder City:

Cardholder Province/State:

Cardholder Postal/ZIP Code (A1A1A1, no spaces):

Cardholder Country:

Payment Information

Credit Card Information:

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Credit Card Number:

Expiration Date:Select month of credit card Select Expiration Year

CVV Number: What is this?