Your donations will help us continue our mission of providing high quality medical and social services that are accessible and affordable for everyone, regardless of ability to pay.

Waikiki Health Center is a 501(c)(3) organization and your gift is tax-deductible (to the full extent of the law).

Giving is easy!

• Donate online through our secure form (below)
• Print out a donation form and mail it to us. (Get the Adobe Acrobat Reader here.)
• Donate by phone (using Visa or MasterCard). Call us at 922-4788.

Donation Amount
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Donor Information
*First Name:
*Last Name:
Org./Bus. Name:
*Mailing Address Line 1:
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*City
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*ZIP/Postal Code
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E-mail
How did you hear about us?	Patient/Client of Waikiki Health Center Friend/Family Member Received Postal Mail Internet Search Engine Television Commercial Other
If Other, please explain:
OPTIONAL: Matching Gift Information:
Will this donation be potentially matched? If you know this information about your matching gift, please complete.
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In Memory Of:
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