Your Fundraiser

In two easy steps

  • 1

    Upload Bill

  • 2

    Fundraiser Info

Please select the name of the facility as it appears in Google Maps

You can upload a document (PDF), a photo of the bill, or an Explanation of Benefits from your insurer

You can add up the total costs of estimates or bills received

This will help us recommend experienced care provided to other patients

We request that you omit sensitive data from bills, including your name, address and other personal information. By submitting your medical records, you are choosing to publicly share your protected health information, which is otherwise protected from disclosure by your health care provider under the Health Insurance Portability and Accountability Act.

This picture will be used in your fundraiser. You can preview it before starting your fundraiser.

Why are you fundraising? The more detail the better to attract funders

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Enter the verification code

A verification code has been sent to the phone number you provided Enter the verification code to verify your phone number and continue