Circle of Companions

CRHS Companions commit to making regular donations to the clinic, typically through their credit card.  Your monthly or quarterly pledge can go far to provide affordable health care and social services to individuals in need in Washington, DC.

Here's how your pledge can make a difference in the lives of our patients:

  • Your $10 per month (about 33 cents a day) pays for a well-child examination, including vaccinations and blood tests for a 0 to 18-month-old baby living under the poverty line.
  • Your $20 per month (about 67 cents a day) provides primary care to a poor or homeless individual for one year.
  • Your $40 a month (about $1.33 a day) offers a year of addictions counseling to an individual in recovery.
  • Your $75 a month (about $2.50 a day) provides one half day of services at CRHS, including health care, social services, dental care and counseling.  It makes you an Associate Friend to CRHS.
  • Your $150 a month (about $5 a day) pays for one full day of services at CRHS and makes you a Friend to the clinic.

Your pledge is both effective and convenient:

  • It provides a steady and predictable source of income for CRHS.
  • We make automatic deductions from your credit card, so there are no hassles or bills to remember for you.
  • You can change the amount or timing of your pledge at any time.
  

To join the Circle of Companions Program, please complete the following form ...

Please provide the following contact information:

First Name
Last Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Home Phone
E-mail

I would like to pledge a contribution of:

$10
$20
$40
$75
$150
Other $

I would like to pay by:

 

Note: If you would like to pay by credit card, the most secure option is for you to call Jenna Udren at (202) 328-3717 x258.  You can also mail your credit card information to CRHS at:

Columbia Road Health Services
1660 Columbia Road, NW
Washington, DC 20009

Please send me charge verification/receipt: