​​Friends of Indiana Hospitals Contribution Club Levels

$5,000+ 1898 Society
$2,500​ – ​$4,999 Champions Club
$1,000 – $2,499  Ben Franklin Club​
$500 – $999 Chairman's Circle Club 
$350 – $499 Capitol Club ​​
$150 – $349 Helen H. Barrett Club 

Please note that this is a two step process. 

  1. Please complete the form below for IHA records.
  2. Once you submit the form below you will be directed to a PayPal donation portal. 
    It is important that you add the donation amount at the top of the PayPal donation payment processing page along with your payment information in order for your donation to be processed completely.

Donation (Step 1 of 2)

About You

About Your Hospital

About Your Donation

For questions, please email Melissa V​ise or call 317-423-7731​.