Make your check payable to Memorial Hospital, and mail it to:
Attn: Patty Dawsey, Community Outreach
91 Hospital Drive
Towanda, Pa. 18848
Call Donna Blair with Credit Card info at: (570) 268-2417
BY EMAIL OR FAX:
You may fax this completed form to (570) 268-2392, or email it to email@example.com.