Make A Donation To The Patient Profile Fund

Please use the form below to make a donation to the Patient Profile Fund. After you fill out the form and check the reCaptcha form you will be redirected to PayPal to complete your purchase.

Make A Donation To The Patient Profile Fund
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Payment

Please complete your purchase below. First, click the reCAPTCHA box. Then click the payment button that will take you to PayPal in order to complete your payment securely..
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Contact Us

1325 San Marco Boulevard, Suite 802
Jacksonville, FL 32207
Phone: 904.202.2886
Fax: 904.202.2778
Email: womensboard@bmcjax.com