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Submitted URL: https://ochsnerphilanthropy.org/1V85-8DFI4-1DKOHO-59077J-1/c.aspx
Effective URL: https://giving.ochsner.org/site/Donation2?df_id=1500&mfc_pref=T&1500.donation=form1&utm_campaign=14063548_Newsletter%20-%20...
Submission: On November 30 via api from US — Scanned from DE
Effective URL: https://giving.ochsner.org/site/Donation2?df_id=1500&mfc_pref=T&1500.donation=form1&utm_campaign=14063548_Newsletter%20-%20...
Submission: On November 30 via api from US — Scanned from DE
Form analysis 1 forms found in the DOM
Name: process — POST https://giving.ochsner.org/site/Donation2
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<h1 class="alter_title">Support the Excellence Fund</h1>
<!-- <img style="float: left; margin: 10px; margin-left: 0; width:30%; height:auto; " src="../images/content/pagebuilder/excellence_fund_img.jpg" alt="Milk Bank volunteer Susan Ginsberg and milk technician Brandy Blanchard process milk. The Milk Bank at Ochsner Baptist began from an Excellence Fund grant application submitted in 2015.">
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Fund at Ochsner is an unrestricted fund that is supported entirely by the generosity of our donors. Annually, teams throughout Ochsner submit applications and a committee selects projects to receive support from the fund. These
projects create opportunities for improvements and innovations in patient care that are changing and saving lives every day. Since 2013, donors have helped support nearly 180 projects! In 2019, donors like you made 32 innovative
projects possible! <a href="https://www.ochsner.org/giving/donate/excellence-fund">Read more</a> about the projects that your generosity has funded since 2013. <br> Milk Bank volunteer Susan Ginsberg and milk technician Brandy
Blanchard process milk. The Milk Bank at Ochsner Baptist began from an Excellence Fund grant application submitted in 2015.</span></p>
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<span class="field-required"></span> <span class="aural-only">Field Is Required</span> Gift Designation:
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<option selected="selected" value="0">Select a Designation type</option>
<option value="1">Other Areas to Support</option>
<option value="2">Support Education at Ochsner</option>
<option value="3">Support John Ochsner Heart and Vascular Institute</option>
<option value="4">Support Ochsner Cancer Institute</option>
<option value="5">Support Ochsner Hospital for Children</option>
<option value="6">Support Ochsner Multi-Organ Transplant Institute</option>
<option value="7">Support Ochsner Neuroscience Institute </option>
<option value="8">Support Ochsner Baptist</option>
<option value="9">Support Ochsner in Baton Rouge</option>
<option value="10">Support Ochsner in New Orleans</option>
<option value="11">Support Women's and Infant's Services</option>
<option value="12">Support Patient Assistance at Ochsner</option>
<option value="13">Support Ochsner Orthopedics</option>
<option value="14">Support Diversity and Inclusion</option>
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<option selected="selected" value="0">Select a Specific Designation</option>
<optgroup label="Other Areas to Support" type_id="1">
<option value="1202"
desc="The Ochsner Blood Bank currently supports over 70% of Ochsner's blood needs for patients at Ochsner hospitals. In addition, Ochsner Blood Bank participates in blood-resource sharing with other local community hospitals. The Blood Bank Fund supports blood bank education and enhancements to help support the Blood Bank's mission to provide an adequate and safe blood supply for the hospitals and communities that Ochsner serves."
image_link="861041121-BloodBank.jpg">Blood Bank Fund</option>
<option value="1045"
desc="Your gift to the Healing Garden Fund will help provide a quiet place for respite and healing therapy to children and families at the Michael R. Boh Center for Childhood Development.
The Ella West Freeman Foundation will match gifts 1:1 up to $266,000! Double your impact today by donating to the Healing Garden Fund.
Garden “rooms” will be constructed with a variety of surface materials to help children as they learn to walk or manage a wheelchair over grass, gravel, pavement, curbs, and other real-life challenges that many of us take for granted. The garden’s sights, smells, and sounds will stimulate the senses and provide a welcome outdoor experience. A “hands on” garden area will provide therapeutic play opportunities for fine motor skill development as children plant and tend seedlings and use garden tools with occupational therapists. The garden will also offer a safe space to introduce social groups for supporting peer-to-peer communication skills and group socialization facilitated by therapists."
image_link="861131162-Boh Center Healing Garden Fund.jpg">Boh Center Healing Garden Fund</option>
<option value="1047" desc="The Community Health Innovation Fund will be utilized by the Community Health Team for patient care, training, programs and other items deemed necessary for the team to provide the highest quality care."
image_link="861031165-Community Health Innovation Fund.jpg">Community Health Innovation Fund</option>
<option value="1044"
desc="Ochsner Digital Medicine helps patients manage their chronic conditions from home while staying connected to a dedicated care team. Using advanced analytics, our care team is able to create a personalized plan for patients to help them reach their goals–one small, manageable step at a time."
image_link="869001024-Digital Medicine Program.jpg">Digital Medicine Program Fund</option>
<option value="1075"
desc="Each year, hundreds of employees from across Ochsner have sought help during times of tragedy or financial stress. The Emergency Response Fund is there to ensure that help is readily available. In 2021, the Emergency Response Fund provided support to employees by offering assistance for hurricane relief and in 2022, it provided relief following the tornadoes that hit Louisiana. This critical fund helps employees across Ochsner, regardless of region, giving them a place to turn when the unthinkable happens. Your support is crucial to its success."
image_link="861031149-Emergency Response Fund.jpg">Emergency Response Fund</option>
<option value="1073"
desc="Gifts to support the Employee Assistance Fund have provided crucial support and timely resources. The Employee Assistance Fund is used to support employees across Ochsner during times of intense need.
The Employee Assistance fund is a confidential process and the funds are disbursed to employees for personal hardships which can include loss of spouse job, home disasters, unexpected medical bills, death of family members, or unexpected home expenses that can prevent employees from paying rent/mortgage, utilities and basic necessitates. Employees that receive funding from the Employee Assistance Fund continue to be appreciative of all the help provided through this program. "
image_link="861021003-Employee Emergency Assistance Fund.jpg">Employee Emergency Assistance Fund</option>
<option value="1022" desc="The Excellence Fund at Ochsner supports improvements and innovations in patient care that are changing and saving lives every day. Annually, teams throughout Ochsner submit applications and a committee selects projects to receive support from the fund. These projects create opportunities for improvements and innovations in patient care that are changing and saving lives every day. Since 2013, donors have helped support 283 projects!
Our donors are our heroes. Your gift to support the Excellence Fund at Ochsner funded a project to increase the number of babies we can transport via helicopter. Because of our partnership with Acadian Ambulance, Flight Care has the ability to operate out of two helicopters. We assisted in evacuating three hospitals in Lake Charles during Hurricane Laura and had to transport several neonates to New Orleans via ground ambulance. These were patients that would have been flown in a helicopter if we have the ability to configure the second for babies. You have ensured that babies in our care will have access to this resource in the future.
Your support sends a strong message that no matter how grueling or uncertain things may be, our heroes are never alone. Thank you.
Read more about the projects that donors have funded at ochsner.org/excellencefund.
" image_link="851151002-Excellence Fund.jpg">Excellence Fund</option>
<option value="1001"
desc="Dr.Yvens Laborde helped establish Ochsner’s Haitian Relief Fund, which helps fund academic and medical mission trips for University of Queensland and Ochsner Clinical School students. It was his belief that beyond providing urgently needed medical care after the devastating earthquake there in 2010, that the experience would change these future physicians for the better.
The Haitians are a proud and resilient people who are always willing to accept a hand extended in mutual respect. Your support is needed now more than ever. Your generosity provides direct humanitarian, medical, educational and developmental aid of those we serve in collaboration with our FONDYLSAHH partners in Haiti."
image_link="861141008-Haitian Relief Fund.jpg">Haitian Relief Fund</option>
<option value="1049" desc="The Health Equity Fund supports health equity initiatives including but not limited to research, education, patient care and community outreach. " image_link="869001021-Health Equity Fund.jpg">
Health Equity Fund</option>
<option value="1209"
desc="An Internal Medicine doctor is a primary care physician who specialize in preventing, diagnosing and treating diseases that affect adults 18 years of age and older. Ochsner is home to some of the most talented internists in the region – men and women who dedicate their lives to treating the whole person. At Ochsner, we work to build relationships with our patients – relationship that will last for years. Patients don’t just see us when they are sick. They see us to stay well. Our internal medicine specialists are experts at synthesizing complete health information, recognizing patterns and diagnosing and treating complex medical issues. Our excellent internal medicine physicians, combined with our advanced technology provides some of the best medical care for adults in the region. The Internal Medicine Innovation Fund is used to support research, education and patient care to ensure this exceptional level of care."
image_link="861031165-Community Health Innovation Fund.jpg">Internal Medicine Innovation Fund</option>
<option value="1207"
desc="The International Ophthalmology Innovation Fund supports patient assistance and educational opportunities along with the purchase of medical equipment, software programs or other program developments necessary for International Ophthalmology patient care. The fund also allows Ochsner physicians and residents to travel outside of the United States to perform procedures and treat vision impairments for those patients that do not have access to care."
image_link="861031135-Ophthalmology.jpg">International Ophthalmology Fund</option>
<option value="1422"
desc="Nourish the mission of Eat Fit today and help us support our Eat Fit restaurant partners in the most meaningful way. Every contribution, big or small, makes a tremendous impact. Eat Fit, a nonprofit initiative of Ochsner Health, launched in 2013 to identify nutritious options in restaurants and markets to help make the healthy choice the easy (and delicious) choice! Your generosity supports the nonprofit work we do for our partners and for our community. Thank you for supporting our Eat Fit mission to inspire our community to live their strongest, healthiest lives!"
image_link="861141006-OchsnerEatFit.png">Ochsner Eat Fit </option>
<option value="1048"
desc="The Palliative CarePalliative Innovation and Education Fund supports direct patient care. Future plans for the program include music therapists, a speaker series, patient assistance funds and fellowship funding in addition to education, training of fellows, the provision of chaplains and grand rounds."
image_link="861031109-Palliative Care Innovation Fund.jpg">Palliative Care Innovation Fund</option>
<option value="1054"
desc="The Patty Hanson Nursing Excellence Fund was established in 2015 by her loving husband, John Hanson, to honor Patty's legacy as a nurse at Ochsner. "She was such an example of what it is to be patient-centered. To her, the patient was her father, her mother, her brother. That was her nature," said John.
"We started with the idea of giving nurses money to advance their studies and their research, but then we learned about Ochsner's educational alliance agreement with Chamberlain Nursing School," said John. The fund is now being used to provide scholarships to aspiring nurses and nurses who want to advance their careers. The following aspiring nurses have received scholarships thanks to the generosity of donors: Samantha O. (Spring 2022), Christian W. (Fall 2021), Tegan M. (Spring 2021), Ovena D. (Fall 2020), Sonja S. (Summer 2020), Kaitlynn M. (Spring 2020), Michelle T. (Fall 2019), Jada D. and Princess J. (Summer 2019)."
image_link="861031099-Patty Hanson Nursing Excellence Fund.jpg">Patty Hanson Nursing Excellence Fund</option>
<option value="1041"
desc="The Pet Therapy Innovation Fund supports Pet Therapy Service. Through this wonderful program patients can take a break from the stress of a hospital stay and enjoy a visit with a furry friend instead. Their wagging tails bring comfort to patients who might be having a hard time finding a reason to smile. To know that our program is helping them get through their days a little easier is amazing. Thank you for ensuring the future of the program through your generosity. Donor support will be used to help pay for dues, certifications and appreciation items for pets and their owners. We are also working with a local groomer to create a partnership so that visiting pets can receive a bath 24 hours or less before they visit the hospital."
image_link="861131005-Pet Therapy Innovation Fund.jpg">Pet Therapy Innovation Fund</option>
<option value="1125"
desc="The Security and Emergency Preparedness Innovation Fund is used to enhance the security of our patients, staff and visitor’s system wide by purchasing state-of-the-art security technology. These systems, such as visitor identification systems, physical access controls, facial recognition cameras, vehicle license plate readers, and biometric readers will be utilized and scaled system-wide to further our system security plan. Emergency preparation notification systems and applications are also needed to expand our already award winning emergency preparation program. In recent years, contributions to the Security and Emergency Preparedness Fund helped expand the Security Department through the addition of Mako, Ochsner's Security K-9 comfort dog. The fund helped cover expenses such as a kennel, training and other supplies. The K-9 program was born out of our workplace violence prevention program to keep all of our employees safe. Needless to say, Mako has been a beloved addition to our Ochsner family."
image_link="861031127-Security and Emergency Preparedness Innovation Fund.jpg">Security and Emergency Preparedness Innovation Fund</option>
</optgroup>
<optgroup label="Support Education at Ochsner" type_id="2">
<option value="1144"
desc="Fellows Travel and Education Funds help provide educational opportunities and resources to fellows. Your generosity ensures the next generation of specialists is armed with the most up-to-date knowledge of treatment options, research and resources for their patients."
image_link="861191014-Anesthesiology Fellows Travel and Education Fund.jpg">Anesthesiology Fellows Travel and Education Fund</option>
<option value="1402"
desc="When a bioethics consult is called, the expectation is that those providing services are well trained, not just people of good will. This training is the responsibility of the Bioethics Committee. Your support of the Bioethics Education Endowment ensures that the committee is confident and steadfast when delivering information and perspectives on difficult health care decisions."
image_link="861191014-Anesthesiology Fellows Travel and Education Fund.jpg">Bioethics Education Endowment</option>
<option value="1149"
desc="Fellows Travel and Education Funds help provide educational opportunities and resources to fellows. Your generosity ensures the next generation of specialists is armed with the most up-to-date knowledge of treatment options, research and resources for their patients."
image_link="861191013-Cardiology Fellows Travel and Education Fund.jpg">Cardiology Fellows Travel and Education Fund</option>
<option value="1205"
desc="“There ought to be some way that a patient can leave your office a little bit better than they came in.” That was the rule that Dr. Richard Deichmann tried to live by for the sake of his own patients. He would provide patients with extra information, look for some small way to bring them comfort or point them in the direction of community resources they didn’t know existed. Anything to make a patient feel like their day-to-day life had improved after a visit with him. That, after all, is what drew him to medicine in the first place. In honor of Dr. Richard Deichmann, the Dr. Richard Deichmann Endowed Professorship in Primary Care was created. The Professorship will support Clinical Educators in becoming experts and leaders in medical education while continuing to train future generations of caregivers in New Orleans."
image_link="861031165-Community Health Innovation Fund.jpg">Dr. Richard Deichmann Endowment Fund</option>
<option value="1220"
desc="The Dr. Terence D'Souza Fellowship in Neuroscience fund supports a vital pipeline of junior investigators in neuroscience. Each year, the fellowship will support the research of a graduating University of Queensland medical student for a six-month period at Ochsner prior to their residency."
image_link="861191013-Cardiology Fellows Travel and Education Fund.jpg">Dr. Terence D'Souza Fellowship in Neuroscience</option>
<option value="1221"
desc="Donors to the Emergency Medicine Frontline Physician Education and Wellness Fund support the development and enhancement of training opportunities for those pursuing careers in Emergency Medicine. Thank you for helping ensure that future emergency medicine providers have access to the best education available so that they can provide exceptional care for years to come when patients need it the most."
image_link="561021000-OLG Employee Assistance Fund.jpg">Emergency Medicine Frontline Physician Education and Wellness</option>
<option value="1146"
desc="Fellows Travel and Education Funds help provide educational opportunities and resources to fellows. Your generosity ensures the next generation of specialists is armed with the most up-to-date knowledge of treatment options, research and resources for their patients."
image_link="861191021-Gastroenterology Fellows Travel and Education Fund.jpg">Gastroenterology Fellows Travel and Education Fund</option>
<option value="1225"
desc="Fellows Travel and Education Funds help provide educational opportunities and resources to fellows. Your generosity ensures the next generation of specialists is armed with the most up-to-date knowledge of treatment options, research and resources for their patients. The Pain Medicine Fellowship Fund supports educational activities, meetings, seminars and lectures for participants in the Interventional Pain Fellowship."
image_link="861191014-Anesthesiology Fellows Travel and Education Fund.jpg">Interventional Pain Medicine Fellowship Fund</option>
<option value="1230"
desc="The Institutional Review Board (IRB) at Ochsner ensures that the rights and wellbeing of research participants are protected. Your generosity supports the education and training of the IRB to ensure that the highest ethical standards possible are observed and employed throughout the research process. "
image_link="861051022-General Cancer Fund.jpg">Norma and John Freiberg IRB Education Endowed Fund</option>
<option value="1059"
desc="Gifts to nursing education create opportunities for training and spur innovations that improve patient care across Ochsner Health. The Nursing Education Fund provides support for research and education for nurses at Ochsner who demonstrate a commitment to continuously improve patient care and to delivery quality care to patients and families. Thank you for providing these incredible opportunities for our front line heroes!"
image_link="861041027-Nursing Education Grant Fund.png">Nursing Education Grant Fund</option>
<option value="1150"
desc="Fellows Travel and Education Funds help provide educational opportunities and resources to fellows. Your generosity ensures the next generation of specialists is armed with the most up-to-date knowledge of treatment options, research and resources for their patients."
image_link="861191019-Ophthalmology Fellows Travel and Education Fund.jpg">Ophthalmology Fellows Travel and Education Fund</option>
<option value="1233"
desc="Providing excellent care requires a commitment to lifelong learning and to the ongoing development of expertise. Donors to the Pharmacy Education Fund help support that by providing development opportunities for pharmacy team members at Ochsner Health."
image_link="861031139-St. Charles Community Innovate Fund.jpeg">Pharmacy Education Fund</option>
<option value="1147"
desc="Fellows Travel and Education Funds help provide educational opportunities and resources to fellows. Your generosity ensures the next generation of specialists is armed with the most up-to-date knowledge of treatment options, research and resources for their patients."
image_link="861191005-Psychiatry Fellows Travel and Education Fund.jpg">Psychiatry Fellows Travel and Education Fund</option>
<option value="1148"
desc="Fellows Travel and Education Funds help provide educational opportunities and resources to fellows. Your generosity ensures the next generation of specialists is armed with the most up-to-date knowledge of treatment options, research and resources for their patients."
image_link="861191016-Pulmonary Disease Fellows Travel and Education Fund.jpg">Pulmonary Disease Fellows Travel and Education Fund</option>
<option value="1143"
desc="Fellows Travel and Education Funds help provide educational opportunities and resources to fellows. Your generosity ensures the next generation of specialists is armed with the most up-to-date knowledge of treatment options, research and resources for their patients."
image_link="861191011-Radiology Fellows Travel and Education Fund.jpg">Radiology Fellows Travel and Education Fund</option>
<option value="1023"
desc="Before, during and after surgery, patients are cared for by some of the most skilled and experienced medical professionals. Our surgeons, anesthesiologists, nurses, specialists, social workers and other healthcare professionals work with the patient and their family to ensure a safe, smooth and comfortable surgery and recovery. The purpose of the Surgical Education Support Fund is to provide financial sponsorship in support of continuing education to ensure that level of care."
image_link="861041040-Surgical Education Support Fund.jpg">Surgical Education Support Fund</option>
</optgroup>
<optgroup label="Support John Ochsner Heart and Vascular Institute" type_id="3">
<option value="1050"
desc="There is hope and it’s closer than you think. It’s right here at Ochsner. With treatment options so revolutionary they aren't available anywhere else in the region, the award-winning cardiology team at Ochsner is dedicated to changing and saving lives, and helping our patients fight back against heart disease. The Cardiology Department Fund supports patient care, education, training, equipment and technology to ensure this outstanding level of care is available."
image_link="861031087-Cardiology Department Fund.jpg">Cardiology Department Fund</option>
<option value="1052"
desc="There is hope and it’s closer than you think. It’s right here at Ochsner. With treatment options so revolutionary they aren't available anywhere else in the region, the award-winning cardiology team at Ochsner is dedicated to changing and saving lives, and helping our patients fight back against heart disease. The Cardiology Rehab and CCU Fund supports research and academic efforts to ensure the future of innovative cardiac care."
image_link="861041094-Cardiology Rehab and CCU Fund.jpg">Cardiology Rehab and CCU Fund</option>
<option value="1051"
desc="For more than 57 years, Dr. John Ochsner was a consistent, larger-than-life presence in Ochsner's halls, patient rooms and surgery suites. His sphere of influence spanned generations of Ochsner physicians and colleagues, and those of us fortunate to have known him are better people because of him. He dedicated nearly six decades of his life to the advancement of medical quality in New Orleans, and served prominently in the numerous community and civic organizations with which he was associated. His life and legacy will live on, not only at Ochsner, but throughout the country thanks to the countless lives that he changed and saved. The John Ochsner, MD Scholar Fund builds upon his legacy by supporting innovations in cardiac care."
image_link="861031090-John Ochsner, M.D. Tribute Fund.jpg">John Ochsner, M.D. Tribute Fund</option>
<option value="1401"
desc="Heart disease affects men and women differently. The aim of the Women's Cardiovascular Clinic at Ochsner is to reduce the burden of heart disease in women through education and research. Your support will help ensure that women at risk have more opportunities for education and preventative care."
image_link="861141022-Women's Wellness and Survivorship Center Fund.jpg">Women's Cardiac Care Innovation Fund</option>
</optgroup>
<optgroup label="Support Ochsner Cancer Institute" type_id="4">
<option value="1521"
desc="The Breast Surgery Recovery Fund offers support to patients facing breast cancer and is used to help them through their journey to recovery. This support may include the expense of bras and pads used after surgery, education for the patient and other necessary items and assistance. "
image_link="861141022-Women's Wellness and Survivorship Center Fund.jpg">Breast Surgery Recovery Fund</option>
<option value="1064"
desc="It’s no secret that Dr. David Margolin was an outstanding colon and rectal surgeon and educator. What you might not know is that Dr. Margolin, Dave, was every bit as outstanding in terms of loyalty, compassion, high expectations and honesty. His contributions to Ochsner, to patients, to former trainees—to people like you—are immeasurable. Your support helps honor him and preserves that legacy through the the Dr. David Allen Margolin, Colon and Rectal Surgery Endowment."
image_link="881081175-Dr. David Margolin C&R Surgery Endowed Fund.jpg">Dr. David Margolin C&R Surgery Endowed Fund</option>
<option value="1062" desc="The General Cancer Fund supports any and all needs of cancer care and chemotherapy at Ochsner. " image_link="861051022-General Cancer Fund.jpg">General Cancer Fund</option>
<option value="1239" desc="The Melanoma/Skin Cancer Program Fund helps support the prevention, diagnosis and treatment for skin cancer while increasing participation in research and education. "
image_link="861051022-General Cancer Fund.jpg">Melanoma and Skin Cancer Program Fund</option>
<option value="1240"
desc="In medicine, the term “zebra” is used to describe a rare condition. To avoid misdiagnosing patients, medical students are taught to assume that the simplest explanation is usually the correct one. They’re told, “When you hear the sound of hooves, think horses, not zebras.” The problem is “zebras” do exist and getting a diagnosis and treatment plan is often difficult for those with rare diseases such as neuroendocrine tumors (NETs). When it comes to treating NETs, however, the team at NOLANETS has earned its' stripes. An affiliation between Louisiana State University Health Science Center and Ochsner Medical Center, NOLANETS is one of the largest NET programs in the country, a leader in the diagnosis and management of all forms of neuroendocrine tumors. Our team’s dedication has led to superior outcomes for patients with NETs in the United States and abroad. The Neuroendocrine Tumor Innovation Fund was established to help support the purchase of novel equipment, the development of new radio-therapeutics and other new treatment options at the Neuroendocrine Tumor Clinic at Ochsner Medical-Center Kenner. This fund will also support educational programs that would help to raise awareness and educate physicians and the general public about these rare tumors and their treatment options."
image_link="861051022-General Cancer Fund.jpg">Neuroendocrine Tumor Innovation Fund</option>
<option value="1063"
desc="For over 70 years, Ochsner has been dedicated to cancer research and new cancer treatment development, bringing innovations to the fight against cancer— including more clinical trials than anywhere else in the region. Patients work with a team of cancer specialists so they have the benefit of knowledge that can make all the difference in their treatment, quality of life and recovery. Ochsner provides cancer services for adult and pediatric cancer patients and their families from diagnosis through recovery, including the most complex and difficult to treat cancers. Gifts to the Ochsner Cancer Institute help increase education, advance innovation and heal patients across the region. Thank you for your generosity."
image_link="861031084-Ochsner Cancer Institute.jpg">Ochsner Cancer Institute</option>
<option value="1241"
desc="The Precision Cancer Therapies Program is bringing access to the latest in cancer therapeutics, research and advanced diagnostics to the region, allowing patients to stay close to home for treatment. Ochsner's longstanding tradition of bringing physicians together to improve health outcomes continues today. Through research-enabled medicine and early phase/phase 1 clinical trials, this program works increase cancer survival rates. Your generosity helps to ensure this lifesaving care is available. "
image_link="861051022-General Cancer Fund.jpg">Precision Cancer Therapies Program Fund</option>
<option value="1581" desc="The Thomas Letard Family Assistance Fund offers assistance and support to brain cancer patients and their families during times of financial crisis." image_link="ScansonComputer.jpeg">Thomas
Letard Family Assistance Fund</option>
<option value="1243"
desc="The mission of the Ochsner Health Department of Urology is to provide the most comprehensive urologic care possible, emphasizing the needs of the individual patient in a compassionate setting. We strive to deliver excellent urologic services through an integrated, multidisciplinary approach that combines clinical experience, education and research. We also aim to make significant contributions to the field of urology through ongoing clinical research and training of future urologic specialists. The Urology services at Ochsner are dedicated to providing state-of-the-art medical and surgical care in all aspects of urology including highly sophisticated technologies such as robotic assisted surgery, extracorporeal shock wave lithotripsy and laser therapies. Our urological team provides comprehensive and specialized urologic medical and surgical care. High-quality and personalized urology care in the areas of adult and general urology, pediatric urology, urologic gynecology, and urological oncology, urinary incontinence, erectile dysfunction, testicular cancer and surgical and non-surgical treatment of kidney stones. The Urology Program Fund supports the needs of the Department of Urology including items that make an impact on patient care such as equipment and research. "
image_link="861051022-General Cancer Fund.jpg">Urology Program Fund</option>
</optgroup>
<optgroup label="Support Ochsner Hospital for Children" type_id="5">
<option value="1067"
desc="The Michael R. Boh Center for Child Development is dedicated to improving the lives of children and adolescents with developmental disorders through comprehensive interdisciplinary team evaluations, integrated treatment protocols, high quality evidence-based patient care, direction of special education services, and professional education and research. With the Michael R. Boh Center for Child Development, parents and their families in the Gulf South are able to find the multidisciplinary care, specialty services and the resources they need under one roof.
The Michael R. Boh Center for Child Development is here to help children overcome challenges, develop their unique talents and reach their full potential. For some children, realizing their potential might mean a little extra help in the classroom or special tools to support communication with the world around them. For others, intensive therapies to overcome the effects of complex neuromuscular conditions make all the difference. No matter what the ability or challenge, children and families need reliable, compassionate, coordinated, and comprehensive care in partnership with a team they trust.
The Boh Center offers personalized, family-centered patient care in one location. A care team comprised of experts from many disciplines brought in from all around the country works together to provide a comprehensive, collaborative approach to care. We evaluate, diagnose and create individualized treatment plans for children with neuro-muscular or physical disabilities as well as neuro-cognitive, behavioral and communication related conditions. Thank you to the generous donors who help make this work possible. "
image_link="861001054-Boh Child Development Center.jpg">Boh Child Development Center</option>
<option value="1066" desc="From engaging pediatric patients in medical play and education to bringing a child waiting to go into surgery a smile and a balloon, the Certified Child Life Specialists at Ochsner Hospital for Children work within the medical team using developmental, educational, and therapeutic interventions and play to help to reduce the stress of the medical environment for children and their families. Your generosity helps ensure that they have the resources they need to support patients and their families physical and emotional needs throughout their care at Ochsner.
The Child Life Fund allows the Child Life team to pinpoint unique needs of the patients we serve by improving their healthcare experience and promoting positive coping. We are so grateful to the donors who continually support Child Life Programing. This means support for community partner visits like Prescription Joy, a healthcare nonprofit that promotes healing through human connection and laughter which promotes resiliency and developmental play. It means support for The Audubon Zoo Animal Education Program which provides the unique experience of Zoo animals visiting patients while hospitalized to reinforce our goal of normalization and supports the therapeutic application of animals in the healthcare settings to increase compliance and recovery. It means funding sturdy wagons that are used for patient transport and play that are much less intimidating than traditional hospital options of wheelchairs and stretchers. It means support for patients who come unexpectedly to Ochsner through the Emergency Department or as a patient transfer and need basic hygiene items and supplies throughout their stay. Your support means making a difference for patients in tough situations.
Thank you to the generous donors who help bring our youngest patients' comfort and smiles!" image_link="861031105-Child Life Department Fund.jpg">Child Life Department Fund</option>
<option value="1127"
desc="Through the impassioned advocacy of dedicated Ochsner physicians and staff, Ochsner is an official Reach Out and Read site, serving children in Louisiana through Ochsner pediatricians. Reach Out and Read makes literacy promotion a standard part of pediatric primary care at all Ochsner Health Centers, encouraging children to grow up with books and a love of reading. Reach Out and Read trains doctors and nurses to advise parents about the importance of reading aloud to their children and to give new developmentally appropriate books to kids at pediatric check-ups between the ages of 6 months and 5 years, with a special focus on disadvantaged children. By building on the unique relationship between parents and pediatricians, Reach Out and Read helps families and communities encourage early literacy skills so children enter school prepared for success in reading. "
image_link="869001015-Ochsner Reach Out and Read Fund.jpg">Ochsner Reach Out and Read Fund</option>
<option value="1065"
desc="Each month children and their families from throughout the region travel to Ochsner Hospital for Children for complex, life-saving procedures such as heart surgeries, cancer treatment, organ transplants, and other procedures. Your gift to the Pediatric Innovations Fund is a powerful investment in the health and happiness of these children and their families providing assistance for families in need, funding for patient care, support for research and education and important projects in the community. Thank you for your commitment to our kids."
image_link="861031083-Pediatric Innovations Fund.jpg">Pediatric Innovations Fund</option>
<option value="1661"
desc="As part of Ochsner Cancer Institute, the leading cancer center in the Gulf South, patients at Ochsner Hospital for Children receive a level of care equal to that offered by the most revered pediatric cancer centers in America. At Ochsner Hospital for Children, some of the country’s most dedicated and passionate pediatric specialists, including oncologists, surgeons, neurosurgeons and radiation oncologists, work together to develop a personalized plan of care for each child. Referring pediatricians remain part of our team every step of the way. Our patients also benefit from the wealth of resources available to us as part of the Ochsner Cancer Institute. Together, there’s no cancer our team can’t treat. The Pediatric OncologyAssistance Fund supports care for children with cancer including the purchase of equipment and supplies and supporting patients and families through family assistance."
image_link="861031083-Pediatric Innovations Fund.jpg">Pediatric Oncology Assistance Fund</option>
<option value="1248"
desc="As part of Ochsner Cancer Institute, the leading cancer center in the Gulf South, patients at Ochsner Hospital for Children receive a level of care equal to that offered by the most revered pediatric cancer centers in America. At Ochsner Hospital for Children, some of the country’s most dedicated and passionate pediatric specialists, including oncologists, surgeons, neurosurgeons and radiation oncologists, work together to develop a personalized plan of care for each child. Referring pediatricians remain part of our team every step of the way. Our patients also benefit from the wealth of resources available to us as part of the Ochsner Cancer Institute. Together, there’s no cancer our team can’t treat. The Pediatric Oncology Research Fund supports research for children with cancer."
image_link="861031083-Pediatric Innovations Fund.jpg">Pediatric Oncology Fund</option>
<option value="1302"
desc="The Pediatric Orthopedic Research Fund supports innovations and research for children and their families. Issues like spinal deformities, scoliosis and cerebral palsy can be frightening to face, but your support ensures research continues to provide options for families."
image_link="861031083-Pediatric Innovations Fund.jpg">Pediatric Orthopedic Research Fund</option>
<option value="1381"
desc="Project Adam began in 1999 after the death of Adam Lemel, a 17-year-old Whitefish Bay, WI, high school student who collapsed and died while playing basketball. Adam suffered a Sudden Cardiac Arrest in which ventricular fibrillation occurred, a condition in which the ventricles cannot pump blood into the body. An AED could have saved his life. In the early 2000s, Adam’s story along with similar sudden deaths of seemingly healthy youth launched nationwide and worldwide efforts to increase AED programs in schools. The goal of Poroject Adam is to eradicate sudden cardiac death through school and community infrastructure development supporting prevention initiatives including Heart Safe Schools, advocacy, education and research. Your support helps bring us closer to that goal."
image_link="861031083-Pediatric Innovations Fund.jpg">Project Adam</option>
</optgroup>
<optgroup label="Support Ochsner Multi-Organ Transplant Institute" type_id="6">
<option value="1092"
desc="The Ochsner Multi-Organ Transplant Institute is the busiest, most experienced transplant center in the Gulf South region. In recent years, Ochsner has strengthened our position as an international leader by achieving the highest national benchmarks for quality. By recruiting some of the world’s leading transplant surgeons and physicians, pursuing clinical and research excellence and adding programs for even the rarest and most complex organ transplants, the Ochsner Transplant Institute continues to grow and serve more adult and pediatric patients needing organ transplants in New Orleans, the region and around the world. To date, we have cared for transplant patients from 37 states and 10 countries. Donors to the Brooks Emory, MD Lung Transplant Fund help support this exceptional level of care by providing funding for research, education, equipment and other needs."
image_link="861031125-Brooks Emory, MD Lung Transplant Fund.jpg">Brooks Emory, MD Lung Transplant Fund</option>
<option value="1068" desc="In some cultures, the liver is associated with courage. In the Gulf South, many patients are finding both courage and leading-edge, life-saving care for liver transplants at the Ochsner Multi-Organ Transplant Institute.
In 1984, the first liver transplant in the state was performed at Ochsner and we’re currently home to Louisiana’s only pediatric liver transplant program. To date, our surgeons have performed more than 3,000 adult and pediatric liver transplants – 210 last year alone. This makes Ochsner the most experienced liver transplant center in the Gulf South.
The Liver Transplant Innovative Fund supports exceptional patient care, educational opportunities and other innovations in treatment and research in the field of liver transplant." image_link="861031039-Liver Transplant Innovative Fund.jpg">
Liver Transplant Innovative Fund</option>
<option value="1069"
desc="The Transplant Games of America bring together individuals who have undergone life-saving transplant surgeries, healthcare providers, donors, donor families and others to highlight the benefits of organ donation. The Games began as a way to spread the word about the importance of organ donation. They have since grown into an event that allows donor families to see how their donation has changed someone’s life. It also allows transplant recipients to show the world that having a transplant is a second chance at life. Thank you for supporting Team Louisiana and for allowing participants to make connections and memories that will last a lifetime. (Pictured: Team Louisiana at the 2018 Transplant Games. The 2020 Transplant Games were unable to be held in person due to COVID-19. Instead, competitors participated from home to ensure the safety of everyone involved.) "
image_link="861141005-Transplant Games Fund.jpg">Transplant Games Fund</option>
</optgroup>
<optgroup label="Support Ochsner Neuroscience Institute " type_id="7">
<option value="1258"
desc="The Ochsner Amyotrophic Lateral Sclerosis (ALS) Center offers comprehensive care for patients with ALS and related disorders. The ALS Innovation Fund supports advances in patient care, research and education."
image_link="851031067-Neurosurgery Department Fund.jpg">ALS Innovative Fund</option>
<option value="1266"
desc="The Brain Health and Cognitive Disorders program understands that for most patients their cognitive problem is far from simple. This is why each patient undergoes a thorough work up that can include a neurological evaluation, neuropsychological testing, labs, imaging and other diagnostic tests. This comprehensive and detailed approach allows for better answers and more tailored treatment recommendations. The Alzheimer's Center Innovative Fund is used for the care, study and education of patients with Alzheimer's and related cognitive disorders."
image_link="851031067-Neurosurgery Department Fund.jpg">Alzheimer's Innovative Fund</option>
<option value="1501"
desc="The Brain Health and Cognitive Disorders program understands that for most patients their cognitive problem is far from simple. This is why each patient undergoes a thorough work up that can include a neurological evaluation, neuropsychological testing, labs, imaging and other diagnostic tests. This comprehensive and detailed approach allows for better answers and more tailored treatment recommendations. Your support helps ensure this exceptional level of care is available when it is needed most."
image_link="851031067-Neurosurgery Department Fund.jpg">Brain Health and Research Fund</option>
<option value="1261"
desc="At Ochsner, we understand that the symptoms of MS can vary greatly from patient to patient, which is why our treatment plans consists of coordinated and comprehensive care tailored to fit each patient’s needs. The Ochsner Multiple Sclerosis Center focuses on patient wellness and includes routine counseling on vitamin supplementation, diet, exercise and stress reduction. Ochsner works hard to translate leading-edge research into more sophisticated treatments for patients with MS. Patients travel to the Ochsner Multiple Sclerosis Center from all over the Gulf South for advanced immunotherapies and treatment of symptoms. We also offer on-site mental health services and yoga classes designed specifically for MS patients. The Multiple Sclerosis Development Fund is used to support the Multiple Sclerosis Department including the MS Patient Education and Resource Center and activities such as patient and caregiver education, professional education, programs, events, assistance and support groups."
image_link="851031067-Neurosurgery Department Fund.jpg">Multiple Sclerosis Development Fund</option>
<option value="1072" desc="The Ochsner Neuroscience "Break Through Barriers" Campaign is the first and most important in the department's history - one that will touch each patient we serve and transform the future of Neuroscience regionally and nationally. This bold new institute unites our departments of Neurology, Psychiatry and Neurological Surgery in a new 100,000-square-foot neurosciences building on Main Campus. The result is a multidisciplinary powerhouse where physicians, researchers and care teams work side-by-side to prevent, to treat, to innovate and most importantly to heal our patients and families from diseases of the brain and spine.
Your generosity will "Break Through Barriers" resulting in progress in brain health and help the Ochsner Neuroscience Institute lead the way to groundbreaking care for patients nationwide. "
image_link="861031094-RobertJDebraHPatrickNeuroscienceCenter.png">Neuroscience Center Fund</option>
<option value="1070"
desc="The Ochsner Neuroscience Institute is a nationwide destination center for patients with a wide variety of neurological conditions. In fact, ours is the only center of its kind in the Gulf South to achieve a national ranking from U.S. News & World Report in neurology and neurosurgery. The Neuroscience Innovative Fund enhances patient care, physician education and research for neurological conditions."
image_link="861031034-Neuroscience Innovative Fund.jpg">Neuroscience Innovative Fund</option>
<option value="1071" desc="Your gift to the Neurosurgery Department Fund will support education, clinical research and the improvement of neurological care at Ochsner." image_link="851031067-Neurosurgery Department Fund.jpg">
Neurosurgery Department Fund</option>
<option value="1263"
desc="Parkinson's Disease is a slowly progressive disorder of the brain which can cause tremor, rigidity, difficulty walking, imbalance and "slowing down". While there is still no cure for Parkinson's Disease, management by a Parkinson's Disease Specialist often results in many years of good quality of life. The Parkinson's Disease Innovation Fund provides unrestricted support for patient care and innovation including research, education, equipment and technology."
image_link="851031067-Neurosurgery Department Fund.jpg">Parkinson's Disease Innovation Fund</option>
<option value="1561"
desc="William Rednour “Billy” Legier passed away on July 27, 2019 after a courageous battle with brain cancer. Billy will always be remembered for his love of singing at friends and family events. After his cancer diagnosis, Billy loved volunteering at the Ochsner Chemo Infusion Center where he found fulfillment in bringing comfort and hope to other cancer patients. Thank you for helping to carry on Billy’s legacy through this program which will bring hope, love and laughter through the delivery of music, art and other creative therapies to patients being treated at the Ochsner Neuroscience Institute."
image_link="Web-MusicTherapy.jpg">William "Billy" Legier Creative Therapies Fund</option>
</optgroup>
<optgroup label="Support Ochsner Baptist" type_id="8">
<option value="1236"
desc="The Attack Breast Cancer Early Fund provides breast cancer screening with on site readings for patients with limited financial resources. This fund helps ensure that everyone has access to life-saving screenings, regardless of coverage. Dr. Erica Broussard created the Attack Breast Cancer Early Fund so donors could support the Links in Pink event. I thought, ‘What if we could create a free screening mammogram event for women who are underserved, uninsured and do not have great access to healthcare?’” Dr. Broussard said. “There are women who we can potentially detect breast cancer early on. We just can’t reach them.” Since the first event in 2020, they have held two more events and screened about 70 women for breast cancer."
image_link="861141022-Women's Wellness and Survivorship Center Fund.jpg">Attack Breast Cancer Baptist Fund</option>
<option value="1421" desc="The Jake's Light Women's Palliative Care Fund supports patient care and education at Ochsner Baptist." image_link="861031109-Palliative Care Innovation Fund.jpg">Jake's Light Women's Palliative Care Fund
</option>
</optgroup>
<optgroup label="Support Ochsner in Baton Rouge" type_id="9">
<option value="1252"
desc="The Baton Rouge Cancer Services Fund supports all aspects of cancer care in the Baton Rouge region including renovations, construction and outfitting of clinical space, equipment, artwork, patient care support and educational activities and materials. Recently, the fund has also supported the Chemotherapy Care Companion Program, which provides patients with a complimentary digital thermometer, digital scale and digital blood pressure monitor so that they can check in with a member of their medical team regularly without having to visit in person. By sending these readings to their care team, the patient is offered the peace of mind that changes in their health are being monitored so that issues can be caught early."
image_link="861001012-BatonRougeBuilding.jpg">Baton Rouge Cancer Services</option>
<option value="1301"
desc="The Baton Rouge Pediatric Innovations Fund provides support to patients and their families seeking care in the Baton Rouge region. Your support is a powerful investment in the health and happiness of these children. Thank you for providing assistance for families in need, funding for patient care and support for research and education and important projects in the community. Thank you for your commitment to our kids."
image_link="861031083-Pediatric Innovations Fund.jpg">Baton Rouge Pediatric Innovation Fund</option>
<option value="1250"
desc="Ochsner offers a comprehensive line of services involving the treatment of lung and breathing issues such as Asthma, Bronchitis, COPD and other advanced lung diseases, critical care services and lung transplant. The Baton Rouge Pulmonary Program Fund is used for general support for needs of the Department of Pulmonary in Baton Rouge, including the purchase of equipment and supplies, educational opportunities, patient programs, research and other efforts to ensure exceptional care."
image_link="861001012-BatonRougeBuilding.jpg">Baton Rouge Pulmonary Program Fund</option>
<option value="1249"
desc="Through the impassioned advocacy of dedicated Ochsner physicians and staff, Ochsner is an official Reach Out and Read site, serving children in Louisiana through Ochsner pediatricians. Reach Out and Read makes literacy promotion a standard part of pediatric primary care at all Ochsner Health Centers, encouraging children to grow up with books and a love of reading. Reach Out and Read trains doctors and nurses to advise parents about the importance of reading aloud to their children and to give new developmentally appropriate books to kids at pediatric check-ups between the ages of 6 months and 5 years, with a special focus on disadvantaged children. By building on the unique relationship between parents and pediatricians, Reach Out and Read helps families and communities encourage early literacy skills so children enter school prepared for success in reading. "
image_link="869001015-Ochsner Reach Out and Read Fund.jpg">Baton Rouge Reach Out and Read Fund</option>
</optgroup>
<optgroup label="Support Ochsner in New Orleans" type_id="10">
<option value="1053"
desc="Every year, grateful patients give back to show their appreciation for excellent care they’ve received. Contributions advance vital efforts across Ochsner, including education for physicians and nurses, clinical research, technological innovation and patient care advancements.
Your support will go a long way toward ensuring that every person coming through our doors experiences exceptional medicine and healing. Thank you for your generosity today! Together, we can ensure that Ochsner Health remains a pillar of help, hope and healing for generations to come."
image_link="861031122-Nursing Innovation Fund.jpg">Nursing Innovation Fund</option>
</optgroup>
<optgroup label="Support Women's and Infant's Services" type_id="11">
<option value="1097"
desc="As a leader in neonatal care, Ochsner Baptist understands the importance of human milk in development that cannot be duplicated by commercial formula. Mother’s milk is especially crucial to premature babies and decreases the odds of life-threatening complications and infections. A significant number of preemie moms are not able to breastfeed. Donated human milk is the next best option. The Mothers’ Milk Bank of Louisiana at Ochsner Baptist will collect, process and provide donor human milk to premature and sick babies who need human milk to thrive. Your donation helps ensure life-saving human milk is available to babies in need throughout the region. "
image_link="861011014-Mothers' Milk Bank of Louisiana.jpg">Mothers' Milk Bank of Louisiana</option>
<option value="1098"
desc="The NICU Fund at Ochsner helps support the Neonatal Intensive Care Unit as they provide care to our youngest patients. This support means a lot, especially to the physicians and nurses that work with these patients every day. It means not only ensuring that families have the help they need, but also ensuring that the healthcare teams providing care are highly trained in the newest technologies and methods of care. Thank you for supporting our smallest patients and their families during their time of need."
image_link="861031106-NICU Fund.jpg">NICU Fund</option>
<option value="1096"
desc="The Women's Wellness Center Fund at Ochsner Baptist supports patient education and community outreach at the Women's Wellness and Survivorship Center. The Women’s Wellness and Survivorship Center at Ochsner Baptist offers extended appointments with a doctor who can offer customized services and trusted resources to help patients cope with the stressors of day-to-day life that cause or exacerbate common health issues."
image_link="861141022-Women's Wellness and Survivorship Center Fund.jpg">Women's Wellness and Survivorship Center Fund</option>
</optgroup>
<optgroup label="Support Patient Assistance at Ochsner" type_id="12">
<option value="1481"
desc="If you are caring for someone you love, you are a caregiver. There are different types of caregivers - some are family members, others are friends. Being a caregiver to an individual that has undergone or will undergo major surgery or disease can be mentally and physically challenging. Caregivers often put their own feelings and needs aside. It is important that we remember to care for and educate our caregivers. We can do just that by addressing the educational and mental needs of our caregivers. The Heart Surgery Caregiver and Patient Support Fund provides the necessary tools and resources to help make the unique journey a caregiver embarks upon more manageable. "
image_link="861141022-Women's Wellness and Survivorship Center Fund.jpg">Cardiology Caregiver Support and Education Fund</option>
<option value="1074"
desc="People react to stress in different ways – and for those already challenged, uncertainty, loss and anxiety can be especially hard. At Ochsner, we offer the latest in psychiatric care for adults challenged by depression, anxiety, addiction, bipolar and other mental health disorders. Sometimes that involves medication. Sometimes group therapy. Sometimes family therapy, too. But as comprehensive as our services are, we can’t provide them alone. Ochsner offers direct help through the Code Blue Patient Assistance program. It might help provide transportation to a patient in need, or the funds for medication. One less hurdle might just help move that patient closer to healing. "
image_link="861011026-Code Blue Psychiatry Fund.jpg">Code Blue Psychiatry Fund</option>
<option value="1094"
desc="The Diabetes Patient Assistance Fund helps to reduce the concern that comes from the unforeseen costs of care or a hospital stay. Thanks to philanthropic gifts from people like you, patients assisted by this fund can focus on healing and their family can focus on offering the best support possible. Thank you for helping patients receiving care at Ochsner through the Diabetes Patient Assistance Fund."
image_link="861011068-Diabetes Patient Assistance Fund.jpg">Diabetes Patient Assistance Fund</option>
<option value="1085"
desc="A Ventricular Assist Device (VAD) improves the chances of survival for heart failure patients. This life-saving device provides many with the time they need as they wait for a heart transplant while also providing improved quality of life. The Dr. Cliff Van Meter VAD Patient Assistance Fund helps provide assistance for expenses related to transportation, housing, meals and more as VAD patients seek cardiac care."
image_link="861011041-Dr. Cliff Van Meter VAD Patient Assistance Fund.jpg">Dr. Cliff Van Meter VAD Patient Assistance Fund</option>
<option value="1089"
desc="Extracorporeal membrane oxygenation (ECMO) is a temporary mechanical support system that handles the function of the heart and/or lungs in patients with a variety of cardiac and respiratory problems. It is most commonly used for patients recovering from heart surgery or suffering from cardiac shock, awaiting a heart or lung transplant or heart-assistance device, or battling respiratory conditions. This fund supports patients in need and their families with housing and meals during the hospitalization of their children."
image_link="861011035-ECMO Family Assistance Fund.jpg">ECMO Family Assistance Fund</option>
<option value="1077"
desc="The Greg Smith Transplant Fund helps uninsured and under-insured Ochsner Transplant patients offset some of the expenses of costly maintenance medications and other transplant related expenses. This fund was started with gifts donated in memory of Greg Smith, a Clinical Transplant Coordinator at Ochsner and lives on through the generosity of donors like you. Thank you for helping transplant patients receive this often life-saving assistance."
image_link="861011033-Gregory Smith Transplant Fund.jpg">Gregory Smith Transplant Fund</option>
<option value="1086"
desc="For transplant patients, there is no greater moment than when they get the news that an organ has been found and their life may be saved. But, with this news comes a large number of costs, some of which are unanticipated. These can include hotel stays for family to be close by during recovery, a cell phone to stay in touch with parents or children and lifesaving medications or treatments that the patient needs to survive. The Heart Transplant Patient Assistance Fund offers support for heart transplant and LVAD patients, including patients awaiting a procedure and patients following their procedure."
image_link="861011017-Heart Transplant Patient Assistance Fund.jpg">Heart Transplant Patient Assistance Fund</option>
<option value="1126"
desc="Since 1942, patients across the United States and the world have trusted Ochsner Health to deliver the highest quality care. As a result, over 4,000 international patients seek treatment at Ochsner each year. They also rely on wrap-around financial support that enables them to access vital treatments.
For two patients recently, the Ochsner Israeli Patient and Caregiver Assistance Fund made the difference between life-saving care or unmet medical needs. With limited financial resources, both patients were unable to fully cover the cost of lodging after receiving liver transplants. The Patient Assistance Fund covered their stay in Louisiana, allowing them to recover fully and get back to leading healthy and meaningful lives in their communities."
image_link="861011049-Israeli Patient and Caregiver Assistance Fund.jpg">Israeli Patient and Caregiver Assistance Fund</option>
<option value="1093"
desc="For transplant patients, there is no greater moment than when they get the news that an organ has been found and their life may be saved. But, with this news comes a large number of costs, some of which are unanticipated. These can include hotel stays for family to be close by during recovery, a cell phone to stay in touch with parents or children and lifesaving medications or treatments that the patient needs to survive. The Lung Transplant Patient Assistance Fund helps defray the enormous costs a patient must face, allowing them to celebrate their second chance and heal with less stress. Thank you for providing this often life-saving support."
image_link="861011034-Lung Transplant Patient Assistance Fund.jpg">Lung Transplant Patient Assistance Fund</option>
<option value="1761"
desc="The MedVantage Clinic fund addresses the social needs of patients who do not have resources. Examples include food during appointments for those who have food insecurity, and out-of-pocket costs for medical equipment and services that patients need but cannot afford."
image_link="861011026-Code Blue Psychiatry Fund.jpg">MedVantage Clinic Fund</option>
<option value="1091"
desc="At the neuro-critical care unit at Ochsner Medical Center - Jefferson Highway, patients’ conditions often onset suddenly, leaving their families little time to prepare for the long road ahead. Kelly Jerolleman, a social worker who manages cases at the unit, saw countless families in need of food, lodging and financial assistance when she started the job. “There were so many situations where we couldn’t meet the need,” Kelly said. “We felt we should have something for these people because they were already going through enough.”
With help from the philanthropy department, Kelly and her colleague, Darlene, established a patient assistance fund for Ochsner Neuroscience Institute. The funds cover a range of expenses—including meal cards and transportation—but most commonly go toward Brent House Hotel stays while patients undergo treatment. Adjacent to the hospital, Brent House Hotel is a convenient place for patients’ families to spend the night, especially those from outside New Orleans. “We concentrate so much on the patients sometimes, but their families are a big part of their lives,” Kelly said. “We heal families, too, because we help them understand what the patient is going through.”
Patient assistance funds help to reduce the concern that comes from the unforeseen costs of illness. Things like communication, transportation, lodging and meals can become overwhelming for patients and their families. Thanks to philanthropic gifts from people like you, the Neuroscience Patient Assistance Fund supports the most critically ill neuroscience patients so that they can focus on their care and their family can focus on offering the best support possible."
image_link="861011051-Neuroscience Patient Assistance Fund.jpg">Neuroscience Patient Assistance Fund</option>
<option value="1078"
desc="Patient assistance funds help to reduce the concern that comes from the unforeseen costs of a cancer diagnosis. Things like communication, transportation, lodging and meals can become overwhelming for patients and their families. Thanks to philanthropic gifts from people like you, the Ochsner Cancer Institute Family Assistance Fund helps reduce the financial burden on our cancer patients and their families and ensures no patient misses an appointment due to lack of funds."
image_link="861011019-OCI Family Assistance Fund.jpg">OCI Family Assistance Fund</option>
<option value="1080"
desc="The Patient Assistance Fund helps to reduce the concern that comes from the unforeseen costs of a hospital stay. Things like communication, transportation, lodging and meals can become overwhelming for patients and their families. Thanks to philanthropic gifts from people like you, patients assisted by this fund can focus on healing and their family can focus on offering the best support possible. Thank you for helping patients receiving care at Ochsner through the Patient Assistance Fund."
image_link="861011036-Patient Assistance Fund.jpg">Patient Assistance Fund</option>
<option value="1076"
desc="Patient assistance funds help to reduce the concern that comes from the unforeseen costs of a hospital stay. Things like communication, transportation, lodging and meals can become overwhelming for patients and their families. Thanks to philanthropic gifts from people like you, patients assisted by this fund can focus on healing and their family can focus on offering the best support possible. Thank you for helping our smallest patients and their families during their time of need through the Pediatric Family Assistance Fund."
image_link="861011029-Pediatric Family Assistance Fund.jpg">Pediatric Family Assistance Fund</option>
<option value="1084"
desc="“It’s just those little things don’t seem like a lot to someone when you think well, it’s your health, you have to do it,” she said. “But it really is $100 for a hotel, $100 to get there and back, it adds up every month when you’re considering what we’re spending on the medication just to stay alive.” That is where the Pulmonary Hypertension Patient Assistance Fund at Ochsner aims to relieve stress so that patients can focus on their care. The Patient Assistance Fund helps to lessen the financial burden that the unexpected costs of chronic and long-term illness can have for patients. By covering anything from gas cards for transportation, to meals or medication co-pays, our donors who support the Patient Assistance Fund are making a meaningful impact every day in the lives of our patients."
image_link="861011046-Pulmonary Hypertension Patient Assistance Fund.jpg">Pulmonary Hypertension Patient Assistance Fund</option>
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<optgroup label="Support Ochsner Orthopedics" type_id="13">
<option value="1046" desc="The Ortho Sports Medicine Initiative Fund supports sports medicine research and development for the prevention, treatment and recovery of injuries."
image_link="861031012-Ortho Sports Medicine Initiative Fund.jpg">Ortho Sports Medicine Initiative Fund</option>
<option value="1272"
desc="From the injured athlete anxious to get back on the field to the grandmother who fractured her hip to the little boy who broke his arm falling out of a tree, the Ochsner Department of Orthopedics is here with compassionate, leading-edge care. The Orthopedic Development Fund addresses the needs for education, research, clinical care, prevention and infrastructure for the Orthopedics Department."
image_link="861031012-Ortho Sports Medicine Initiative Fund.jpg">Orthopedic Development Fund</option>
<option value="1145"
desc="From the injured athlete anxious to get back on the field to the grandmother who fractured her hip to the little boy who broke his arm falling out of a tree, the Ochsner Department of Orthopedics is here with compassionate, leading-edge care. The Dr. A. William Dunn Orthopaedic Fund supports educational opportunities and materials to ensure that exceptional care is always available."
image_link="861041049-The Dr. A. William Dunn Orthopaedic Fund.jpg">The Dr. A. William Dunn Orthopaedic Fund</option>
</optgroup>
<optgroup label="Support Diversity and Inclusion" type_id="14">
<option value="1133"
desc="The mission of Asian-American Innovation Movement (AAIM) is to improve the overall well-being and quality of life for patients and employees of the Asian community. Creating cultural awareness through the integration of Diversity and Inclusion efforts for Asian American and Pacific Islander cultures makes us stronger. Their goal is to create an environment that leverages the talents and skills of Ochsner Health’s AAPI employees and provide equitable access to exceptional healthcare for the community. "
image_link="861031155-AAIM Innovation Fund.jpg">AAIM Innovation Fund</option>
<option value="1128"
desc="ABLE - African Americans Building and Leading Inclusion and Equality is an employee resource group at Ochsner. The mission of ABLE is to be a resource and advocate to foster business success, community well-being and the advancement of our workforce. The ABLE Innovation Fund will support: growing professionals in health care fields, investing in employees, increasing educational opportunities, expanding access to technology and health screenings and addressing other social-economic determinants that contribute to health disparities in Louisiana. ABLE wants to drive innovation and build communities. Thank you for donating to the ABLE Innovation Fund so we can implement what we dream!"
image_link="861031154-ABLE Innovation Fund.jpg">ABLE Innovation Fund</option>
<option value="1043"
desc="As healthcare professionals, our purpose is to care for the health and well-being of our patients and employees. To do that well, we must ensure an environment that fosters connections built on respect for diversity and a focus on inclusion. The connections we make with our patients, their loved ones and our teammates are what set Ochsner's culture apart. Nurturing this culture is critical and part of that means accurately representing and celebrating the diversity of the Ochsner team and the communities we serve - including everything from race, gender and age as well as the diverse perspectives and experiences that enrich our team. To highlight and build an appreciation for the differences that make us stronger and to address the need of every individual to feel valued and respected, employee resource groups have been established representing key interests across our organization. The Diversity and Inclusion Innovation Fund supports the activities of these Ochsner Resource Groups to promote diversity at Ochsner's campuses to yield the positive results of inclusion. (Pictured left: Asian-American Innovation Movement brought the Lunar New Year's spirit to Ochsner Medical Center - New Orleans on Jefferson Highway).
Each group is open to all Ochsner employees, no matter the identity. These groups include: Women Empowering WOemn, African Americans Building and Leading Equity, PRIDE, Young Professionals Association, Hispanics at Ochsner Leading and Advocating, Vet Force 1, Asian-American Innovation Movement and Exceptional Abilities."
image_link="861031128-Diversity and Inclusion Innovation Fund.jpg">Diversity and Inclusion Innovation Fund</option>
<option value="1134"
desc="The mission of Exceptional Abilities (EA) is to promote the inclusion and acceptance of people with exceptional abilities by providing advocacy and education on disability awareness. Exceptional Abilities is an official network of Ochsner employees who may or may not have visible/invisible disabilities, family members with exceptional abilities or share a vested interest in supporting this community. The vision of EA is to improve the well-being and overall quality of work and life of our employees and their families with exceptional abilities by identifying opportunities to create a more inclusive environment."
image_link="861031156-EA Innovation Fund.jpg">EA Innovation Fund</option>
<option value="1136"
desc="Globally Linked Ochsner Belonging & Engagement (GLOBE) aims to create a culture of inclusion, tolerance, and mutual understanding at Ochsner for all cultures and beliefs, where all employees and patients feel welcome, included, and supported, enabling Ochsner to become a globally recognized brand that is sought after by a diverse workforce and patient community. "
image_link="861031060-GLOBE Innovation Fund.jpg">GLOBE Innovation Fund</option>
<option value="1132"
desc="The mission of Hispanics at Ochsner Leading and Advocating (HOLA) is to inspire, collaborate and partner with others to promote the value of a diverse and inclusive workforce, support focused recruitment, retention, education, professional development and advancement of Hispanic employees, increase Hispanic representation at all levels across Ochsner and educate, connect and assist members of the Hispanic community."
image_link="861031157-HOLA Innovation Fund.png">HOLA Innovation Fund</option>
<option value="1130"
desc="Ochsner PRIDE works to promote an inclusive community for LGBTQ employees, patients and clients throughout Ochsner. Their focus includes eliminating healthcare disparities in the LGBTQ community, community outreach, mentorship and education on LGBTQ healthcare and disparities. Ochsner PRIDE will serve as a visible, accessible resource for LBGTQ-identified employees and their allies."
image_link="861031158-PRIDE Innovation Fund.png">PRIDE Innovation Fund</option>
<option value="1135"
desc="Resourceful Experienced Team Rises at Ochsner (RETRO) represents a diverse and dynamic population of Ochsner employees that advocates for, and empowers, Generation X and above individuals not only within Ochsner but throughout the community. Through meaningful partnerships and collaborations, RETRO leverages the unique strengths of older individuals to strengthen Ochsner internally and in terms of outreach. This RETRO Innovation Fund will allow RETRO to build programs for the more mature population in our community and to connect them with needed health care resources. Without these important resources, many may go without needed screenings or care. Your support of the RETRO Innovation Fund will help ensure this doesn't happen."
image_link="861031061-RETRO Innovation Fund.jpg">RETRO Innovation Fund</option>
<option value="1129"
desc="Vet Force 1 was formed to support Ochsner Health’s core values and the recruitment, advancement and retention efforts for military personnel as employees. They aim to improve the culture of Ochsner by creating an official care and support network for military employees and their families while also establishing recognition opportunities for employees and patients who are active and veterans of the United States Armed Forces."
image_link="861031161-Vet Force 1 Innovation Fund.png">Vet Force 1 Innovation Fund</option>
<option value="1131"
desc="The mission and vision of WOW is to cultivate an inclusive environment that supports and encourages women to advance their skills and potential through connection, mentorship, collaboration and discussion. This group serves as a forum for women working at Ochsner to find their voice and be heard within Ochsner Health and the community. Through networking, mentoring, outreach, self-care and professional development, we hope to attract and retain women in an organization that allows each to fully realize, actualize and capitalize on their talents."
image_link="861031159-WoW Innovation Fund.png">WoW Innovation Fund</option>
<option value="1137"
desc="The mission of the Young Professionals Association (YPA) is to attract, support, retain, develop and connect young talent. The group serves as an avenue for young professionals to become successful individually and within the organization, while creating a sense that Ochsner is a place of work where they want to stay. Young professionals will connect to our patients, community and fellow employees by being a voice for the organization."
image_link="861031160-YPA Innovation Fund.png">YPA Innovation Fund</option>
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<script type="text/javascript">
var comp = new ObservableComponent('tribute_type', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_type_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('tribute_show_honor_fields.true', new ComponentDisplayer('tribute_type'));
function tribute_type_listChanged(_evt) {
var e = _evt ? _evt : event; // IE vs. Mozilla event model
if (e) {
var src = e.target ? e.target : e.srcElement; // IE vs. Mozilla event model
fire_obs_comp_event('tribute_type', src);
}
}
var el = document.getElementById('tribute_type');
if (el) {
Utils.addEvent(el, 'change', tribute_type_listChanged);
}
</script><noscript> </noscript>
</div>
</div>
<div id="tribute_honoree_first_name_row" class="form-row form-text" style="display: none;">
<div class="form-content">
<span class="field-required"></span>
<label for="tribute_honoree_first_namename">Honoree First Name:</label>
<input type="text" name="tribute_honoree_first_namename" id="tribute_honoree_first_namename" value="" maxlength="50">
<input type="hidden" name="tribute_honoree_first_namesubmit_skip" id="tribute_honoree_first_namesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('tribute_honoree_first_name', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_honoree_first_name_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('tribute_show_honor_fields.true', new ComponentDisplayer('tribute_honoree_first_name'));
</script><noscript> </noscript>
</div>
</div>
<div id="tribute_honoree_last_name_row" class="form-row form-text" style="display: none;">
<div class="form-content">
<span class="field-required"></span>
<label for="tribute_honoree_last_namename">Honoree Last Name:</label>
<input type="text" name="tribute_honoree_last_namename" id="tribute_honoree_last_namename" value="" maxlength="50">
<input type="hidden" name="tribute_honoree_last_namesubmit_skip" id="tribute_honoree_last_namesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('tribute_honoree_last_name', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_honoree_last_name_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('tribute_show_honor_fields.true', new ComponentDisplayer('tribute_honoree_last_name'));
</script><noscript> </noscript>
</div>
</div>
<div id="tribute_message_body_row" class="form-row form-text" style="display: none;">
<div class="form-content">
<span class="field-required"></span>
<label for="tribute_message_bodyname">Message Body:</label>
<textarea cols="50" rows="4" name="tribute_message_bodyname" id="tribute_message_bodyname"></textarea>
<input type="hidden" name="tribute_message_bodysubmit_skip" id="tribute_message_bodysubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('tribute_message_body', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_message_body_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('tribute_show_honor_fields.true', new ComponentDisplayer('tribute_message_body'));
</script><noscript> </noscript>
</div>
</div>
<div id="tribute_notify_recip_name_row" class="form-row form-text" style="display: none;">
<div class="form-content">
<span class="field-required"></span>
<label for="tribute_notify_recip_namename">Notification Recipient Name:</label>
<input type="text" name="tribute_notify_recip_namename" id="tribute_notify_recip_namename" value="" maxlength="70">
<input type="hidden" name="tribute_notify_recip_namesubmit_skip" id="tribute_notify_recip_namesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('tribute_notify_recip_name', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_notify_recip_name_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('tribute_show_honor_fields.true', new ComponentDisplayer('tribute_notify_recip_name'));
</script><noscript> </noscript>
</div>
</div>
<div id="tribute_notify_recip_street1_row" class="form-row form-text" style="display: none;">
<div class="form-content">
<span class="field-required"></span>
<label for="tribute_notify_recip_street1name">Notification Recipient Street 1:</label>
<input type="text" name="tribute_notify_recip_street1name" id="tribute_notify_recip_street1name" value="" maxlength="50">
<input type="hidden" name="tribute_notify_recip_street1submit_skip" id="tribute_notify_recip_street1submit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('tribute_notify_recip_street1', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_notify_recip_street1_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('tribute_show_honor_fields.true', new ComponentDisplayer('tribute_notify_recip_street1'));
</script><noscript> </noscript>
</div>
</div>
<div id="tribute_notify_recip_city_row" class="form-row form-text" style="display: none;">
<div class="form-content">
<span class="field-required"></span>
<label for="tribute_notify_recip_cityname">Notification Recipient City:</label>
<input type="text" name="tribute_notify_recip_cityname" id="tribute_notify_recip_cityname" value="" maxlength="50">
<input type="hidden" name="tribute_notify_recip_citysubmit_skip" id="tribute_notify_recip_citysubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('tribute_notify_recip_city', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_notify_recip_city_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('tribute_show_honor_fields.true', new ComponentDisplayer('tribute_notify_recip_city'));
</script><noscript> </noscript>
</div>
</div>
<div id="tribute_notify_recip_state_row" class="form-row form-selectlist" style="display: none;">
<div class="form-content">
<span class="field-required"></span>
<label class="FormLabel" for="tribute_notify_recip_state">Notification Recipient State/Province:</label>
<select name="tribute_notify_recip_state" id="tribute_notify_recip_state" size="1" onchange="fire_obs_comp_event('tribute_notify_recip_state', this)">
<option></option>
<option value="AK">AK - Alaska</option>
<option value="AL">AL - Alabama</option>
<option value="AR">AR - Arkansas</option>
<option value="AZ">AZ - Arizona</option>
<option value="CA">CA - California</option>
<option value="CO">CO - Colorado</option>
<option value="CT">CT - Connecticut</option>
<option value="DC">DC - District of Columbia</option>
<option value="DE">DE - Delaware</option>
<option value="FL">FL - Florida</option>
<option value="GA">GA - Georgia</option>
<option value="HI">HI - Hawaii</option>
<option value="IA">IA - Iowa</option>
<option value="ID">ID - Idaho</option>
<option value="IL">IL - Illinois</option>
<option value="IN">IN - Indiana</option>
<option value="KS">KS - Kansas</option>
<option value="KY">KY - Kentucky</option>
<option value="LA">LA - Louisiana</option>
<option value="MA">MA - Massachusetts</option>
<option value="MD">MD - Maryland</option>
<option value="ME">ME - Maine</option>
<option value="MI">MI - Michigan</option>
<option value="MN">MN - Minnesota</option>
<option value="MO">MO - Missouri</option>
<option value="MS">MS - Mississippi</option>
<option value="MT">MT - Montana</option>
<option value="NC">NC - North Carolina</option>
<option value="ND">ND - North Dakota</option>
<option value="NE">NE - Nebraska</option>
<option value="NH">NH - New Hampshire</option>
<option value="NJ">NJ - New Jersey</option>
<option value="NM">NM - New Mexico</option>
<option value="NV">NV - Nevada</option>
<option value="NY">NY - New York</option>
<option value="OH">OH - Ohio</option>
<option value="OK">OK - Oklahoma</option>
<option value="OR">OR - Oregon</option>
<option value="PA">PA - Pennsylvania</option>
<option value="RI">RI - Rhode Island</option>
<option value="SC">SC - South Carolina</option>
<option value="SD">SD - South Dakota</option>
<option value="TN">TN - Tennessee</option>
<option value="TX">TX - Texas</option>
<option value="UT">UT - Utah</option>
<option value="VA">VA - Virginia</option>
<option value="VT">VT - Vermont</option>
<option value="WA">WA - Washington</option>
<option value="WI">WI - Wisconsin</option>
<option value="WV">WV - West Virginia</option>
<option value="WY">WY - Wyoming</option>
<option value="AS">AS - American Samoa</option>
<option value="FM">FM - Federated States of Micronesia</option>
<option value="GU">GU - Guam</option>
<option value="MH">MH - Marshall Islands</option>
<option value="MP">MP - Northern Mariana Islands</option>
<option value="PR">PR - Puerto Rico</option>
<option value="PW">PW - Palau</option>
<option value="VI">VI - Virgin Islands</option>
<option value="AA">AA - Armed Forces Americas</option>
<option value="AE">AE - Armed Forces</option>
<option value="AP">AP - Armed Forces Pacific</option>
<option value="AB">AB - Alberta</option>
<option value="BC">BC - British Columbia</option>
<option value="MB">MB - Manitoba</option>
<option value="NB">NB - New Brunswick</option>
<option value="NL">NL - Newfoundland and Labrador</option>
<option value="NS">NS - Nova Scotia</option>
<option value="NT">NT - Northwest Territories</option>
<option value="NU">NU - Nunavut</option>
<option value="ON">ON - Ontario</option>
<option value="PE">PE - Prince Edward Island</option>
<option value="QC">QC - Quebec</option>
<option value="SK">SK - Saskatchewan</option>
<option value="YT">YT - Yukon</option>
<option value="None">None</option>
</select>
<script type="text/javascript">
<!--
var comp = new ObservableComponent('tribute_notify_recip_state', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_notify_recip_state_Row', _display);
this.disable_submit_flag(_hidden);
}
//
-->
</script>
<noscript><br>Required</noscript>
<input type="hidden" name="tribute_notify_recip_statesubmit_skip" id="tribute_notify_recip_statesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('tribute_notify_recip_state', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_notify_recip_state_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('tribute_show_honor_fields.true', new ComponentDisplayer('tribute_notify_recip_state'));
function tribute_notify_recip_state_listChanged(_evt) {
var e = _evt ? _evt : event; // IE vs. Mozilla event model
if (e) {
var src = e.target ? e.target : e.srcElement; // IE vs. Mozilla event model
fire_obs_comp_event('tribute_notify_recip_state', src);
}
}
var el = document.getElementById('tribute_notify_recip_state');
if (el) {
Utils.addEvent(el, 'change', tribute_notify_recip_state_listChanged);
}
</script><noscript> </noscript>
</div>
</div>
<div id="tribute_notify_recip_zip_row" class="form-row form-text" style="display: none;">
<div class="form-content">
<span class="field-required"></span>
<label for="tribute_notify_recip_zipname">Notification Recipient ZIP/Postal Code:</label>
<input type="text" name="tribute_notify_recip_zipname" id="tribute_notify_recip_zipname" value="" maxlength="50">
<input type="hidden" name="tribute_notify_recip_zipsubmit_skip" id="tribute_notify_recip_zipsubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('tribute_notify_recip_zip', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_notify_recip_zip_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('tribute_show_honor_fields.true', new ComponentDisplayer('tribute_notify_recip_zip'));
</script><noscript> </noscript>
</div>
</div>
<div id="tribute_notify_recip_country_row" class="form-row form-selectlist" style="display: none;">
<div class="form-content">
<span class="field-required"></span>
<label class="FormLabel" for="tribute_notify_recip_country">Notification Recipient Country:</label>
<select name="tribute_notify_recip_country" id="tribute_notify_recip_country" size="1" onchange="fire_obs_comp_event('tribute_notify_recip_country', this)">
<option></option>
<option selected="selected" value="United States">United States</option>
<option value="Afghanistan">Afghanistan</option>
<option value="Aland Islands">Aland Islands</option>
<option value="Albania">Albania</option>
<option value="Algeria">Algeria</option>
<option value="American Samoa">American Samoa</option>
<option value="Andorra">Andorra</option>
<option value="Angola">Angola</option>
<option value="Anguilla">Anguilla</option>
<option value="Antarctica">Antarctica</option>
<option value="Antigua and Barbuda">Antigua and Barbuda</option>
<option value="Argentina">Argentina</option>
<option value="Armenia">Armenia</option>
<option value="Aruba">Aruba</option>
<option value="Australia">Australia</option>
<option value="Austria">Austria</option>
<option value="Azerbaijan">Azerbaijan</option>
<option value="Bahamas">Bahamas</option>
<option value="Bahrain">Bahrain</option>
<option value="Bangladesh">Bangladesh</option>
<option value="Barbados">Barbados</option>
<option value="Belarus">Belarus</option>
<option value="Belgium">Belgium</option>
<option value="Belize">Belize</option>
<option value="Benin">Benin</option>
<option value="Bermuda">Bermuda</option>
<option value="Bhutan">Bhutan</option>
<option value="Bolivarian Republic of Venezuela">Bolivarian Republic of Venezuela</option>
<option value="Bonaire, Sint Eustatios and Saba">Bonaire, Sint Eustatios and Saba</option>
<option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option>
<option value="Botswana">Botswana</option>
<option value="Bouvet Island">Bouvet Island</option>
<option value="Brazil">Brazil</option>
<option value="British Indian Ocean Territory">British Indian Ocean Territory</option>
<option value="Brunei Darussalam">Brunei Darussalam</option>
<option value="Bulgaria">Bulgaria</option>
<option value="Burkina Faso">Burkina Faso</option>
<option value="Burundi">Burundi</option>
<option value="Cambodia">Cambodia</option>
<option value="Cameroon">Cameroon</option>
<option value="Canada">Canada</option>
<option value="Cape Verde">Cape Verde</option>
<option value="Cayman Islands">Cayman Islands</option>
<option value="Central African Republic">Central African Republic</option>
<option value="Chad">Chad</option>
<option value="Chile">Chile</option>
<option value="China">China</option>
<option value="Christmas Island">Christmas Island</option>
<option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option>
<option value="Colombia">Colombia</option>
<option value="Comoros">Comoros</option>
<option value="Congo">Congo</option>
<option value="Cook Islands">Cook Islands</option>
<option value="Costa Rica">Costa Rica</option>
<option value="Cote D'Ivoire">Cote D'Ivoire</option>
<option value="Croatia">Croatia</option>
<option value="Cuba">Cuba</option>
<option value="Curacao">Curacao</option>
<option value="Cyprus">Cyprus</option>
<option value="Czech Republic">Czech Republic</option>
<option value="Democratic People's Republic of Korea">Democratic People's Republic of Korea</option>
<option value="The Democratic Republic of the Congo">The Democratic Republic of the Congo</option>
<option value="Denmark">Denmark</option>
<option value="Djibouti">Djibouti</option>
<option value="Dominica">Dominica</option>
<option value="Dominican Republic">Dominican Republic</option>
<option value="Ecuador">Ecuador</option>
<option value="Egypt">Egypt</option>
<option value="El Salvador">El Salvador</option>
<option value="Equatorial Guinea">Equatorial Guinea</option>
<option value="Eritrea">Eritrea</option>
<option value="Estonia">Estonia</option>
<option value="Ethiopia">Ethiopia</option>
<option value="Falkland Islands (Malvinas)">Falkland Islands (Malvinas)</option>
<option value="Faroe Islands">Faroe Islands</option>
<option value="Federated States of Micronesia">Federated States of Micronesia</option>
<option value="Fiji">Fiji</option>
<option value="Finland">Finland</option>
<option value="The Former Yugoslav Republic of Macedonia">The Former Yugoslav Republic of Macedonia</option>
<option value="France">France</option>
<option value="French Guiana">French Guiana</option>
<option value="French Polynesia">French Polynesia</option>
<option value="French Southern Territories">French Southern Territories</option>
<option value="Gabon">Gabon</option>
<option value="Gambia">Gambia</option>
<option value="Georgia">Georgia</option>
<option value="Germany">Germany</option>
<option value="Ghana">Ghana</option>
<option value="Gibraltar">Gibraltar</option>
<option value="Greece">Greece</option>
<option value="Greenland">Greenland</option>
<option value="Grenada">Grenada</option>
<option value="Guadeloupe">Guadeloupe</option>
<option value="Guam">Guam</option>
<option value="Guatemala">Guatemala</option>
<option value="Guernsey">Guernsey</option>
<option value="Guinea">Guinea</option>
<option value="Guinea-Bissau">Guinea-Bissau</option>
<option value="Guyana">Guyana</option>
<option value="Haiti">Haiti</option>
<option value="Heard Island and McDonald Islands">Heard Island and McDonald Islands</option>
<option value="Holy See (Vatican City State)">Holy See (Vatican City State)</option>
<option value="Honduras">Honduras</option>
<option value="Hong Kong">Hong Kong</option>
<option value="Hungary">Hungary</option>
<option value="Iceland">Iceland</option>
<option value="India">India</option>
<option value="Indonesia">Indonesia</option>
<option value="Iraq">Iraq</option>
<option value="Ireland">Ireland</option>
<option value="Islamic Republic of Iran">Islamic Republic of Iran</option>
<option value="Isle of Man">Isle of Man</option>
<option value="Israel">Israel</option>
<option value="Italy">Italy</option>
<option value="Jamaica">Jamaica</option>
<option value="Japan">Japan</option>
<option value="Jersey">Jersey</option>
<option value="Jordan">Jordan</option>
<option value="Kazakhstan">Kazakhstan</option>
<option value="Kenya">Kenya</option>
<option value="Kiribati">Kiribati</option>
<option value="Kuwait">Kuwait</option>
<option value="Kyrgyzstan">Kyrgyzstan</option>
<option value="Lao People's Democratic Republic">Lao People's Democratic Republic</option>
<option value="Latvia">Latvia</option>
<option value="Lebanon">Lebanon</option>
<option value="Lesotho">Lesotho</option>
<option value="Liberia">Liberia</option>
<option value="Libya">Libya</option>
<option value="Liechtenstein">Liechtenstein</option>
<option value="Lithuania">Lithuania</option>
<option value="Luxembourg">Luxembourg</option>
<option value="Macao">Macao</option>
<option value="Madagascar">Madagascar</option>
<option value="Malawi">Malawi</option>
<option value="Malaysia">Malaysia</option>
<option value="Maldives">Maldives</option>
<option value="Mali">Mali</option>
<option value="Malta">Malta</option>
<option value="Marshall Islands">Marshall Islands</option>
<option value="Martinique">Martinique</option>
<option value="Mauritania">Mauritania</option>
<option value="Mauritius">Mauritius</option>
<option value="Mayotte">Mayotte</option>
<option value="Mexico">Mexico</option>
<option value="Monaco">Monaco</option>
<option value="Mongolia">Mongolia</option>
<option value="Montenegro">Montenegro</option>
<option value="Montserrat">Montserrat</option>
<option value="Morocco">Morocco</option>
<option value="Mozambique">Mozambique</option>
<option value="Myanmar">Myanmar</option>
<option value="Namibia">Namibia</option>
<option value="Nauru">Nauru</option>
<option value="Nepal">Nepal</option>
<option value="Netherlands">Netherlands</option>
<option value="New Caledonia">New Caledonia</option>
<option value="New Zealand">New Zealand</option>
<option value="Nicaragua">Nicaragua</option>
<option value="Niger">Niger</option>
<option value="Nigeria">Nigeria</option>
<option value="Niue">Niue</option>
<option value="Norfolk Island">Norfolk Island</option>
<option value="Northern Mariana Islands">Northern Mariana Islands</option>
<option value="Norway">Norway</option>
<option value="Oman">Oman</option>
<option value="Pakistan">Pakistan</option>
<option value="Palau">Palau</option>
<option value="Palestinian Territory, Occupied">Palestinian Territory, Occupied</option>
<option value="Panama">Panama</option>
<option value="Papua New Guinea">Papua New Guinea</option>
<option value="Paraguay">Paraguay</option>
<option value="Peru">Peru</option>
<option value="Philippines">Philippines</option>
<option value="Pitcairn">Pitcairn</option>
<option value="Plurinational State of Bolivia">Plurinational State of Bolivia</option>
<option value="Poland">Poland</option>
<option value="Portugal">Portugal</option>
<option value="Puerto Rico">Puerto Rico</option>
<option value="Qatar">Qatar</option>
<option value="Republic of Korea">Republic of Korea</option>
<option value="Republic of Moldova">Republic of Moldova</option>
<option value="Reunion">Reunion</option>
<option value="Romania">Romania</option>
<option value="Russian Federation">Russian Federation</option>
<option value="Rwanda">Rwanda</option>
<option value="Saint Barthelemy">Saint Barthelemy</option>
<option value="Saint Helena, Ascension and Tristan da Cunha">Saint Helena, Ascension and Tristan da Cunha</option>
<option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option>
<option value="Saint Lucia">Saint Lucia</option>
<option value="Saint Martin (French)">Saint Martin (French)</option>
<option value="Saint Pierre and Miquelon">Saint Pierre and Miquelon</option>
<option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option>
<option value="Samoa">Samoa</option>
<option value="San Marino">San Marino</option>
<option value="Sao Tome and Principe">Sao Tome and Principe</option>
<option value="Saudi Arabia">Saudi Arabia</option>
<option value="Senegal">Senegal</option>
<option value="Serbia">Serbia</option>
<option value="Seychelles">Seychelles</option>
<option value="S. Georgia & S. Sandwich Isls.">S. Georgia & S. Sandwich Isls.</option>
<option value="Sierra Leone">Sierra Leone</option>
<option value="Singapore">Singapore</option>
<option value="Sint Maarten (Dutch)">Sint Maarten (Dutch)</option>
<option value="Slovakia">Slovakia</option>
<option value="Slovenia">Slovenia</option>
<option value="Solomon Islands">Solomon Islands</option>
<option value="Somalia">Somalia</option>
<option value="South Africa">South Africa</option>
<option value="South Sudan">South Sudan</option>
<option value="Spain">Spain</option>
<option value="Sri Lanka">Sri Lanka</option>
<option value="Sudan">Sudan</option>
<option value="Suriname">Suriname</option>
<option value="Svalbard and Jan Mayen">Svalbard and Jan Mayen</option>
<option value="Swaziland">Swaziland</option>
<option value="Sweden">Sweden</option>
<option value="Switzerland">Switzerland</option>
<option value="Syrian Arab Republic">Syrian Arab Republic</option>
<option value="Taiwan, Province of China">Taiwan, Province of China</option>
<option value="Tajikistan">Tajikistan</option>
<option value="Thailand">Thailand</option>
<option value="Timor-Leste">Timor-Leste</option>
<option value="Togo">Togo</option>
<option value="Tokelau">Tokelau</option>
<option value="Tonga">Tonga</option>
<option value="Trinidad and Tobago">Trinidad and Tobago</option>
<option value="Tunisia">Tunisia</option>
<option value="Turkey">Turkey</option>
<option value="Turkmenistan">Turkmenistan</option>
<option value="Turks and Caicos Islands">Turks and Caicos Islands</option>
<option value="Tuvalu">Tuvalu</option>
<option value="Uganda">Uganda</option>
<option value="Ukraine">Ukraine</option>
<option value="United Arab Emirates">United Arab Emirates</option>
<option value="United Kingdom">United Kingdom</option>
<option value="United Republic of Tanzania">United Republic of Tanzania</option>
<option value="Uruguay">Uruguay</option>
<option value="USA Minor Outlying Islands">USA Minor Outlying Islands</option>
<option value="Uzbekistan">Uzbekistan</option>
<option value="Vanuatu">Vanuatu</option>
<option value="Viet Nam">Viet Nam</option>
<option value="Virgin Islands (British)">Virgin Islands (British)</option>
<option value="Virgin Islands (USA)">Virgin Islands (USA)</option>
<option value="Wallis and Futuna">Wallis and Futuna</option>
<option value="Western Sahara">Western Sahara</option>
<option value="Yemen">Yemen</option>
<option value="Zambia">Zambia</option>
<option value="Zimbabwe">Zimbabwe</option>
</select>
<script type="text/javascript">
<!--
var comp = new ObservableComponent('tribute_notify_recip_country', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_notify_recip_country_Row', _display);
this.disable_submit_flag(_hidden);
}
//
-->
</script>
<noscript><br>Required</noscript>
<input type="hidden" name="tribute_notify_recip_countrysubmit_skip" id="tribute_notify_recip_countrysubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('tribute_notify_recip_country', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('tribute_notify_recip_country_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('tribute_show_honor_fields.true', new ComponentDisplayer('tribute_notify_recip_country'));
function tribute_notify_recip_country_listChanged(_evt) {
var e = _evt ? _evt : event; // IE vs. Mozilla event model
if (e) {
var src = e.target ? e.target : e.srcElement; // IE vs. Mozilla event model
fire_obs_comp_event('tribute_notify_recip_country', src);
}
}
var el = document.getElementById('tribute_notify_recip_country');
if (el) {
Utils.addEvent(el, 'change', tribute_notify_recip_country_listChanged);
}
</script><noscript> </noscript>
</div>
</div>
<h2 class="section-header-container"> Billing Information </h2>
<div id="billing_title_row" class="form-row form-selectlist">
<div class="form-content">
<label class="FormLabel" for="billing_title">Billing Title:</label>
<select name="billing_title" id="billing_title" size="1">
<option></option>
<option value="Mr.">Mr.</option>
<option value="Ms.">Ms.</option>
<option value="Mrs.">Mrs.</option>
<option value="Miss">Miss</option>
<option value="Dr.">Dr.</option>
</select>
<script type="text/javascript">
<!--
var comp = new ObservableComponent('billing_title', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_title_Row', _display);
this.disable_submit_flag(_hidden);
}
//
-->
</script>
<noscript><br>Required</noscript>
<input type="hidden" name="billing_titlesubmit" id="billing_titlesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_title', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_title_row', _display);
this.disable_submit_flag(_hidden);
}
function billing_title_listChanged(_evt) {
var e = _evt ? _evt : event; // IE vs. Mozilla event model
if (e) {
var src = e.target ? e.target : e.srcElement; // IE vs. Mozilla event model
fire_obs_comp_event('billing_title', src);
}
}
var el = document.getElementById('billing_title');
if (el) {
Utils.addEvent(el, 'change', billing_title_listChanged);
}
</script><noscript> </noscript>
</div>
</div>
<div id="billing_first_name_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="billing_first_namename">First Name:</label>
<input type="text" name="billing_first_namename" id="billing_first_namename" value="" maxlength="50">
<input type="hidden" name="billing_first_namesubmit" id="billing_first_namesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_first_name', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_first_name_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="billing_last_name_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="billing_last_namename">Last Name:</label>
<input type="text" name="billing_last_namename" id="billing_last_namename" value="" maxlength="50">
<input type="hidden" name="billing_last_namesubmit" id="billing_last_namesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_last_name', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_last_name_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="organization-name-visible_row" class="form-row form-checkbox">
<div class="form-content">
<input type="checkbox" name="organization-name-visiblename" id="organization-name-visiblename" onclick="fire_obs_comp_event('organization-name-visible', this);">
<label for="organization-name-visiblename">Make this gift on behalf of an organization</label>
<input type="hidden" name="organization-name-visiblesubmit" id="organization-name-visiblesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('organization-name-visible', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('organization-name-visible_row', _display);
this.disable_submit_flag(_hidden);
}
comp.set = function(_value) {
if (document.getElementById('organization-name-visiblename')) {
document.getElementById('organization-name-visiblename').checked = _value;
this.fireEvent();
}
}
comp.get = function() {
if (document.getElementById('organization-name-visiblename')) {
return document.getElementById('organization-name-visiblename').checked;
}
}
comp.clear = function() {
this.set(false);
}
</script><noscript> </noscript>
</div>
</div>
<div id="donor-organization-name_row" class="form-row form-text" style="display: none;">
<div class="form-content">
<span class="field-required"></span>
<label for="donor-organization-namename">Organization Name:</label>
<input type="text" name="donor-organization-namename" id="donor-organization-namename" value="" maxlength="255" disabled="">
<input type="hidden" name="donor-organization-namesubmit_skip" id="donor-organization-namesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('donor-organization-name', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('donor-organization-name_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('organization-name-visible.true', new ComponentEnabler('donor-organization-name'));
observe_component('organization-name-visible.true', new ComponentDisplayer('donor-organization-name'));
</script><noscript> </noscript>
</div>
</div>
<div id="billing_addr_street1_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="billing_addr_street1name">Street 1:</label>
<input type="text" name="billing_addr_street1name" id="billing_addr_street1name" value="" maxlength="50">
<input type="hidden" name="billing_addr_street1submit" id="billing_addr_street1submit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_addr_street1', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_addr_street1_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="billing_addr_street2_row" class="form-row form-text">
<div class="form-content">
<label for="billing_addr_street2name">Street 2:</label>
<input type="text" name="billing_addr_street2name" id="billing_addr_street2name" value="" maxlength="50">
<input type="hidden" name="billing_addr_street2submit" id="billing_addr_street2submit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_addr_street2', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_addr_street2_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="billing_addr_city_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="billing_addr_cityname">City:</label>
<input type="text" name="billing_addr_cityname" id="billing_addr_cityname" value="" maxlength="50">
<input type="hidden" name="billing_addr_citysubmit" id="billing_addr_citysubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_addr_city', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_addr_city_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="billing_addr_state_row" class="form-row form-selectlist">
<div class="form-content">
<span class="field-required"></span>
<label class="FormLabel" for="billing_addr_state">State/Province:</label>
<select name="billing_addr_state" id="billing_addr_state" size="1" onchange="fire_obs_comp_event('billing_addr_state', this)">
<option></option>
<option value="AK">AK - Alaska</option>
<option value="AL">AL - Alabama</option>
<option value="AR">AR - Arkansas</option>
<option value="AZ">AZ - Arizona</option>
<option value="CA">CA - California</option>
<option value="CO">CO - Colorado</option>
<option value="CT">CT - Connecticut</option>
<option value="DC">DC - District of Columbia</option>
<option value="DE">DE - Delaware</option>
<option value="FL">FL - Florida</option>
<option value="GA">GA - Georgia</option>
<option value="HI">HI - Hawaii</option>
<option value="IA">IA - Iowa</option>
<option value="ID">ID - Idaho</option>
<option value="IL">IL - Illinois</option>
<option value="IN">IN - Indiana</option>
<option value="KS">KS - Kansas</option>
<option value="KY">KY - Kentucky</option>
<option value="LA">LA - Louisiana</option>
<option value="MA">MA - Massachusetts</option>
<option value="MD">MD - Maryland</option>
<option value="ME">ME - Maine</option>
<option value="MI">MI - Michigan</option>
<option value="MN">MN - Minnesota</option>
<option value="MO">MO - Missouri</option>
<option value="MS">MS - Mississippi</option>
<option value="MT">MT - Montana</option>
<option value="NC">NC - North Carolina</option>
<option value="ND">ND - North Dakota</option>
<option value="NE">NE - Nebraska</option>
<option value="NH">NH - New Hampshire</option>
<option value="NJ">NJ - New Jersey</option>
<option value="NM">NM - New Mexico</option>
<option value="NV">NV - Nevada</option>
<option value="NY">NY - New York</option>
<option value="OH">OH - Ohio</option>
<option value="OK">OK - Oklahoma</option>
<option value="OR">OR - Oregon</option>
<option value="PA">PA - Pennsylvania</option>
<option value="RI">RI - Rhode Island</option>
<option value="SC">SC - South Carolina</option>
<option value="SD">SD - South Dakota</option>
<option value="TN">TN - Tennessee</option>
<option value="TX">TX - Texas</option>
<option value="UT">UT - Utah</option>
<option value="VA">VA - Virginia</option>
<option value="VT">VT - Vermont</option>
<option value="WA">WA - Washington</option>
<option value="WI">WI - Wisconsin</option>
<option value="WV">WV - West Virginia</option>
<option value="WY">WY - Wyoming</option>
<option value="AS">AS - American Samoa</option>
<option value="FM">FM - Federated States of Micronesia</option>
<option value="GU">GU - Guam</option>
<option value="MH">MH - Marshall Islands</option>
<option value="MP">MP - Northern Mariana Islands</option>
<option value="PR">PR - Puerto Rico</option>
<option value="PW">PW - Palau</option>
<option value="VI">VI - Virgin Islands</option>
<option value="AA">AA - Armed Forces Americas</option>
<option value="AE">AE - Armed Forces</option>
<option value="AP">AP - Armed Forces Pacific</option>
<option value="AB">AB - Alberta</option>
<option value="BC">BC - British Columbia</option>
<option value="MB">MB - Manitoba</option>
<option value="NB">NB - New Brunswick</option>
<option value="NL">NL - Newfoundland and Labrador</option>
<option value="NS">NS - Nova Scotia</option>
<option value="NT">NT - Northwest Territories</option>
<option value="NU">NU - Nunavut</option>
<option value="ON">ON - Ontario</option>
<option value="PE">PE - Prince Edward Island</option>
<option value="QC">QC - Quebec</option>
<option value="SK">SK - Saskatchewan</option>
<option value="YT">YT - Yukon</option>
<option value="None">None</option>
</select>
<script type="text/javascript">
<!--
var comp = new ObservableComponent('billing_addr_state', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_addr_state_Row', _display);
this.disable_submit_flag(_hidden);
}
//
-->
</script>
<noscript><br>Required</noscript>
<input type="hidden" name="billing_addr_statesubmit" id="billing_addr_statesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_addr_state', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_addr_state_row', _display);
this.disable_submit_flag(_hidden);
}
function billing_addr_state_listChanged(_evt) {
var e = _evt ? _evt : event; // IE vs. Mozilla event model
if (e) {
var src = e.target ? e.target : e.srcElement; // IE vs. Mozilla event model
fire_obs_comp_event('billing_addr_state', src);
}
}
var el = document.getElementById('billing_addr_state');
if (el) {
Utils.addEvent(el, 'change', billing_addr_state_listChanged);
}
</script><noscript> </noscript>
</div>
</div>
<div id="billing_addr_zip_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="billing_addr_zipname">ZIP/Postal Code:</label>
<input type="text" name="billing_addr_zipname" id="billing_addr_zipname" value="" maxlength="50">
<input type="hidden" name="billing_addr_zipsubmit" id="billing_addr_zipsubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('billing_addr_zip', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('billing_addr_zip_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="donor_phone_row" class="form-row form-text">
<div class="form-content">
<label for="donor_phonename">Donor Phone Number:</label>
<input type="text" name="donor_phonename" id="donor_phonename" value="" maxlength="50">
<input type="hidden" name="donor_phonesubmit" id="donor_phonesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('donor_phone', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('donor_phone_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="donor_email_address_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="donor_email_addressname">Email Address:</label>
<input type="text" name="donor_email_addressname" id="donor_email_addressname" value="" maxlength="255">
<input type="hidden" name="donor_email_addresssubmit" id="donor_email_addresssubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('donor_email_address', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('donor_email_address_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div class="form-row form-checkbox" id="donor_email_opt_in_Row">
<div class="form-content">
<span class="check-box-form-label-text"></span>
<input type="checkbox" name="donor_email_opt_inname" id="donor_email_opt_inname" checked="checked" onclick="fire_obs_comp_event('donor_email_opt_in', this);">
<label for="donor_email_opt_inname"> Yes, I'd like to receive email updates from this organization. </label>
<script type="text/javascript">
var comp = new ObservableComponent('donor_email_opt_in', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('donor_email_opt_in_Row', _display);
this.disable_submit_flag(_hidden);
}
comp.set = function(_value) {
if (document.getElementById('donor_email_opt_inname')) {
document.getElementById('donor_email_opt_inname').checked = _value;
this.fireEvent();
}
}
comp.get = function() {
if (document.getElementById('donor_email_opt_inname')) return document.getElementById('donor_email_opt_inname').checked;
}
comp.clear = function() {
this.set(false);
}
</script><noscript> </noscript>
<input type="hidden" name="donor_email_opt_insubmit" id="donor_email_opt_insubmit" value="true">
</div>
</div>
<h2 class="section-header-container"> Payment Information </h2>
<div class="payment-type-element-container">
<div class="payment-type-selection-container payment-field-container">
<h3>Payment Method:</h3>
<div id="responsive_payment_typepay_typeradio_row" class="form-row">
<div class="form-content">
<div class="payment-type-selections" id="responsive_payment_typepay_typeradio_payment_types">
<span class="internal-payment"><span class="payment-type-option selected"><input type="radio" name="responsive_payment_typepay_typeradio" id="responsive_payment_typepay_typeradiocredit" value="credit" checked="checked"
onclick="fire_obs_comp_event('responsive_payment_typepay_typeradio', this);" onkeypress="fire_obs_comp_event('responsive_payment_typepay_typeradio', this);"><label
for="responsive_payment_typepay_typeradiocredit"><a href="javascript:void(0);" class="payment-type-label">Credit Card</a></label>
<script type="text/javascript">
var comp = new ObservableRadioComponent('responsive_payment_typepay_typeradio', 'name');
</script><noscript> </noscript>
</span><span class="payment-type-option"><input type="radio" name="responsive_payment_typepay_typeradio" id="responsive_payment_typepay_typeradioach" value="ach"
onclick="fire_obs_comp_event('responsive_payment_typepay_typeradio', this);" onkeypress="fire_obs_comp_event('responsive_payment_typepay_typeradio', this);"><label
for="responsive_payment_typepay_typeradioach"><a href="javascript:void(0);" class="payment-type-label">Checking Account</a></label>
<script type="text/javascript">
var comp = new ObservableRadioComponent('responsive_payment_typepay_typeradio', 'name');
</script><noscript> </noscript>
</span></span>
<span class="external-payment"></span>
</div>
<input type="hidden" name="responsive_payment_typepay_typeradiosubmit" id="responsive_payment_typepay_typeradiosubmit" value="true">
<script type="text/javascript">
Y.use("jquery-ui", function(Y) {
jQuery(function() {
// subscribe observable for payment type options
jQuery('.payment-type-option').each(function() {
var syncAction = function(obj) {
if (obj.hasClass('selected')) {
var radioGroupName = obj.find('input').attr('name');
obj.find('input').prop('checked', true);
fire_obs_comp_event(radioGroupName, obj.find('input').get());
}
return arguments.callee;
}(jQuery(this));
jQuery(this).click(function() {
jQuery('.payment-type-option').removeClass('selected');
jQuery(this).addClass('selected');
syncAction(jQuery(this));
var selectedValue = jQuery(this).find('input').val();
if (selectedValue == 'paypal' || selectedValue == 'amazon') {
// open up a boxinator dialog
jQuery(document).trigger('redirect-external');
jQuery('#btn_next').click();
}
});
});
});
});
var comp = new ObservableRadioComponent('responsive_payment_typepay_typeradio', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typepay_typeradio_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
</div>
<div id="payment_cc_container" class="payment-field-container">
<h3>Credit Card Information:</h3>
<div id="responsive_payment_typecc_type_row" class="form-row form-radio-array">
<div class="form-content">
<fieldset>
<legend>Credit Card Type:</legend>
<ul class="radio-array-list">
<li class="tender-row ">
<img src="../images/discovercard_sm.gif" alt="Discover" name="responsive_payment_typecc_type_Discover" id="responsive_payment_typecc_type_Discover">
</li>
<li class="tender-row ">
<img src="../images/amex_small.gif" alt="American Express" name="responsive_payment_typecc_type_American_Express" id="responsive_payment_typecc_type_American_Express">
</li>
<li class="tender-row ">
<img src="../images/mastercd_small.gif" alt="MasterCard" name="responsive_payment_typecc_type_MasterCard" id="responsive_payment_typecc_type_MasterCard">
</li>
<li class="tender-row ">
<img src="../images/visa_small.gif" alt="Visa" name="responsive_payment_typecc_type_Visa" id="responsive_payment_typecc_type_Visa">
</li>
</ul>
</fieldset>
<input type="hidden" name="responsive_payment_typecc_typesubmit" id="responsive_payment_typecc_typesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableRadioComponent('responsive_payment_typecc_type', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typecc_type_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="responsive_payment_typecc_number_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="responsive_payment_typecc_numbername">Credit Card Number:</label>
<input type="text" name="responsive_payment_typecc_numbername" id="responsive_payment_typecc_numbername" value="" maxlength="22" autocomplete="off">
<input type="hidden" name="responsive_payment_typecc_numbersubmit" id="responsive_payment_typecc_numbersubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('responsive_payment_typecc_number', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typecc_number_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('null', new ComponentDisplayer('responsive_payment_typecc_number'));
</script><noscript> </noscript>
</div>
</div>
<div id="responsive_payment_typecc_exp_date_row" class="form-row form-date">
<div class="form-content">
<span class="field-required"></span>
<label for="responsive_payment_typecc_exp_date_MONTH">
<span class="label-text">Expiration Date:</span><span class="aural-only">Select month of credit card</span>
</label>
<label for="responsive_payment_typecc_exp_date_YEAR"><span class="aural-only">Select Expiration Year</span></label>
<div class="date-input-container">
<fieldset class="cardExpGroup">
<select name="responsive_payment_typecc_exp_date_MONTH" id="responsive_payment_typecc_exp_date_MONTH" onchange="fire_obs_comp_event('responsive_payment_typecc_exp_date_MONTH', this)">
<option value="1">01</option>
<option value="2">02</option>
<option value="3">03</option>
<option value="4">04</option>
<option value="5">05</option>
<option value="6">06</option>
<option value="7">07</option>
<option value="8">08</option>
<option value="9">09</option>
<option value="10">10</option>
<option value="11" selected="selected">11</option>
<option value="12">12</option>
</select>
<select name="responsive_payment_typecc_exp_date_YEAR" id="responsive_payment_typecc_exp_date_YEAR" onchange="fire_obs_comp_event('responsive_payment_typecc_exp_date_YEAR', this)">
<option value="2023" selected="selected">2023</option>
<option value="2024">2024</option>
<option value="2025">2025</option>
<option value="2026">2026</option>
<option value="2027">2027</option>
<option value="2028">2028</option>
<option value="2029">2029</option>
<option value="2030">2030</option>
<option value="2031">2031</option>
<option value="2032">2032</option>
<option value="2033">2033</option>
</select>
</fieldset>
<input type="hidden" name="responsive_payment_typecc_exp_date_DAY" id="responsive_payment_typecc_exp_date_DAY" value="1">
<script type="text/javascript">
<!--
var comp1 = new ObservableComponent('responsive_payment_typecc_exp_date_MONTH', '');
comp1.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typecc_exp_date_Row', _display);
this.disable_submit_flag(_hidden);
}
var comp2 = new ObservableComponent('responsive_payment_typecc_exp_date_YEAR', '');
comp2.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typecc_exp_date_Row', _display);
this.disable_submit_flag(_hidden);
}
//
-->
</script><noscript> </noscript>
</div>
<input type="hidden" name="responsive_payment_typecc_exp_datesubmit" id="responsive_payment_typecc_exp_datesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('responsive_payment_typecc_exp_date', 'input');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typecc_exp_date_row', _display);
disable_submit_flag('responsive_payment_typecc_exp_datesubmit', _hidden);
}
comp.disable = function(_disabled) {
disable_element('responsive_payment_typecc_exp_date_MONTH', _disabled);
disable_element('responsive_payment_typecc_exp_date_DAY', _disabled);
disable_element('responsive_payment_typecc_exp_date_YEAR', _disabled);
disable_element('responsive_payment_typecc_exp_date_HOUR12', _disabled);
disable_element('responsive_payment_typecc_exp_date_HOUR24', _disabled); //For UK, 24 hour clock used
disable_element('responsive_payment_typecc_exp_date_MINUTE', _disabled);
disable_element('responsive_payment_typecc_exp_date_AMPM', _disabled);
}
</script><noscript> </noscript>
</div>
</div>
<div id="responsive_payment_typecc_cvv_row" class="form-row form-text cvv-input">
<div class="form-content">
<span class="field-required"></span>
<label for="responsive_payment_typecc_cvvname">
<span class="FormLabelText">CVV Number:</span>
</label>
<a href="http://help.convio.net/site/PageServer?s_site=ochhs&pagename=user_donation_cvv" class="HelpLink" title="What is this? Opens new window.">What is this?</a>
<input type="text" name="responsive_payment_typecc_cvvname" id="responsive_payment_typecc_cvvname" value="" maxlength="4" autocomplete="cc-csc">
<input type="hidden" name="responsive_payment_typecc_cvvsubmit" id="responsive_payment_typecc_cvvsubmit" value="true">
<script type="text/javascript">
//chrome is mapping cvv as card name
if (/CriOS/.test(navigator.userAgent) || (/Chrome/.test(navigator.userAgent) && /Google Inc/.test(navigator.vendor))) {
document.getElementById('responsive_payment_typecc_cvvname').autocomplete = 'cc-csc';
}
var comp = new ObservableComponent('responsive_payment_typecc_cvv', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typecc_cvv_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
</div>
<div id="payment_bank_container" class="payment-field-container" style="display: none;">
<h3>Checking Account Information:</h3>
<div id="responsive_payment_typerouting_number_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="responsive_payment_typerouting_numbername">Bank Routing Number:</label>
<a href="http://help.convio.net/site/PageServer?s_site=ochhs&pagename=User_Donation_ACH" class="HelpLink" title="What is this? Opens new window.">What is this?</a>
<input type="text" name="responsive_payment_typerouting_numbername" id="responsive_payment_typerouting_numbername" value="" size="20" maxlength="20" onchange="fire_obs_comp_event('responsive_payment_typerouting_number', this);"
autocomplete="off">
<input type="hidden" name="responsive_payment_typerouting_numbersubmit" id="responsive_payment_typerouting_numbersubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('responsive_payment_typerouting_number', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typerouting_number_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="responsive_payment_typebank_account_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="responsive_payment_typebank_accountname">Bank Account Number:</label>
<input type="text" name="responsive_payment_typebank_accountname" id="responsive_payment_typebank_accountname" value="" maxlength="20" autocomplete="off">
<input type="hidden" name="responsive_payment_typebank_accountsubmit" id="responsive_payment_typebank_accountsubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('responsive_payment_typebank_account', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typebank_account_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('null', new ComponentDisplayer('responsive_payment_typebank_account'));
</script><noscript> </noscript>
</div>
</div>
<div id="responsive_payment_typeverify_bank_account_row" class="form-row form-text">
<div class="form-content">
<span class="field-required"></span>
<label for="responsive_payment_typeverify_bank_accountname">Verify Bank Account Number:</label>
<input type="text" name="responsive_payment_typeverify_bank_accountname" id="responsive_payment_typeverify_bank_accountname" value="" maxlength="20" autocomplete="off">
<input type="hidden" name="responsive_payment_typeverify_bank_accountsubmit" id="responsive_payment_typeverify_bank_accountsubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('responsive_payment_typeverify_bank_account', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typeverify_bank_account_row', _display);
this.disable_submit_flag(_hidden);
}
observe_component('null', new ComponentDisplayer('responsive_payment_typeverify_bank_account'));
</script><noscript> </noscript>
</div>
</div>
<div id="responsive_payment_type.account_type_row" class="form-row form-radio-array">
<div class="form-content">
<fieldset>
<legend><span class="field-required"></span> Account Type:</legend>
<ul class="radio-array-list">
<li>
<input type="radio" name="responsive_payment_type.account_type" id="responsive_payment_type.account_type_responsive_payment_typeaccount_type_checking" value="CHECKING"
onclick="fire_obs_comp_event('responsive_payment_type.account_type', this);">
<span class="radio-label">
<label for="responsive_payment_type.account_type_responsive_payment_typeaccount_type_checking">Checking</label>
</span>
</li>
<li>
<input type="radio" name="responsive_payment_type.account_type" id="responsive_payment_type.account_type_responsive_payment_typeaccount_type_savings" value="SAVINGS"
onclick="fire_obs_comp_event('responsive_payment_type.account_type', this);">
<span class="radio-label">
<label for="responsive_payment_type.account_type_responsive_payment_typeaccount_type_savings">Savings</label>
</span>
</li>
</ul>
</fieldset>
<input type="hidden" name="responsive_payment_type.account_typesubmit" id="responsive_payment_type.account_typesubmit" value="true">
<script type="text/javascript">
var comp = new ObservableRadioComponent('responsive_payment_type.account_type', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_type.account_type_row', _display);
this.disable_submit_flag(_hidden);
}
</script><noscript> </noscript>
</div>
</div>
<div id="responsive_payment_typeach_confirm_row" class="form-row form-checkbox">
<div class="form-content">
<span class="field-required"></span>
<input type="checkbox" name="responsive_payment_typeach_confirmname" id="responsive_payment_typeach_confirmname" onclick="fire_obs_comp_event('responsive_payment_typeach_confirm', this);">
<label for="responsive_payment_typeach_confirmname">By checking this option, I agree to use my bank account as a payment method and authorize this organization to debit my bank account to fulfill my donation commitment.</label>
<input type="hidden" name="responsive_payment_typeach_confirmsubmit" id="responsive_payment_typeach_confirmsubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('responsive_payment_typeach_confirm', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('responsive_payment_typeach_confirm_row', _display);
this.disable_submit_flag(_hidden);
}
comp.set = function(_value) {
if (document.getElementById('responsive_payment_typeach_confirmname')) {
document.getElementById('responsive_payment_typeach_confirmname').checked = _value;
this.fireEvent();
}
}
comp.get = function() {
if (document.getElementById('responsive_payment_typeach_confirmname')) {
return document.getElementById('responsive_payment_typeach_confirmname').checked;
}
}
comp.clear = function() {
this.set(false);
}
observe_component('null', new ComponentEnabler('responsive_payment_typeach_confirm'));
</script><noscript> </noscript>
</div>
</div>
</div>
<div id="payment_check_container" class="payment-field-container" style="display: none;">
<h3>Check Information</h3>
</div>
<input type="hidden" name="responsive_payment_typesubmit" id="responsive_payment_typesubmit" value="true">
<script type="text/javascript">
function PaymentObserver() {
this.observe = function(_event) {
var sVal = _event.component.get();
switch (sVal) {
case 'check':
hide_element('payment_cc_container');
hide_element('payment_bank_container');
show_element('payment_check_container');
break;
case 'credit':
hide_element('payment_bank_container');
hide_element('payment_check_container');
show_element('payment_cc_container');
break;
case 'ach':
hide_element('payment_cc_container');
hide_element('payment_check_container');
show_element('payment_bank_container');
break;
case 'paypal':
case 'amazon':
case 'mobilepay':
default:
// hide all
hide_element('payment_bank_container');
hide_element('payment_cc_container');
hide_element('payment_check_container');
break;
}
}
}
// Set the observer to show/hide the relevant fields
observe_component('responsive_payment_typepay_typeradio', new PaymentObserver());
</script><noscript> </noscript>
</div>
<div id="anonymous_donation_row" class="form-row form-checkbox">
<div class="form-content">
<input type="checkbox" name="anonymous_donationname" id="anonymous_donationname" onclick="fire_obs_comp_event('anonymous_donation', this);">
<label for="anonymous_donationname">I would like to make this donation anonymously</label>
<input type="hidden" name="anonymous_donationsubmit" id="anonymous_donationsubmit" value="true">
<script type="text/javascript">
var comp = new ObservableComponent('anonymous_donation', 'name');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('anonymous_donation_row', _display);
this.disable_submit_flag(_hidden);
}
comp.set = function(_value) {
if (document.getElementById('anonymous_donationname')) {
document.getElementById('anonymous_donationname').checked = _value;
this.fireEvent();
}
}
comp.get = function() {
if (document.getElementById('anonymous_donationname')) {
return document.getElementById('anonymous_donationname').checked;
}
}
comp.clear = function() {
this.set(false);
}
</script><noscript> </noscript>
</div>
</div>
<h2 class="section-header-container"> Employer Matching Information </h2>
<div class="employer-address-container " "="">
<div class=" form-row">
</div>
<div class="form-row">
<div class="form-content" id="employer_match_label_row">
<span class="section-label hidden"> TODO: employer address label </span>
</div>
</div>
<div class="form-row">
<div class="form-content" id="employer_name_row">
<label for="employer_name">Employer Name:</label>
<input type="text" name="employer_name" id="employer_name" value="" onchange="fire_obs_comp_event('employer_name', this);">
</div>
</div>
<div class="form-row">
<div class="form-content" id="employer_street_row">
<label for="employer_street">Employer Address:</label>
<input type="text" name="employer_street" id="employer_street" value="" onchange="fire_obs_comp_event('employer_street', this);">
</div>
</div>
<div class="form-row">
<div class="form-content" id="employer_city_row">
<label for="employer_city">Employer City:</label>
<input type="text" name="employer_city" id="employer_city" value="" onchange="fire_obs_comp_event('employer_city', this);">
</div>
</div>
<div class="form-row">
<div class="form-content" id="employer_state_row">
<label for="employer_state">Employer State: </label>
<select name="employer_state" id="employer_state" size="1">
<option></option>
<option value="AK">AK - Alaska</option>
<option value="AL">AL - Alabama</option>
<option value="AR">AR - Arkansas</option>
<option value="AZ">AZ - Arizona</option>
<option value="CA">CA - California</option>
<option value="CO">CO - Colorado</option>
<option value="CT">CT - Connecticut</option>
<option value="DC">DC - District of Columbia</option>
<option value="DE">DE - Delaware</option>
<option value="FL">FL - Florida</option>
<option value="GA">GA - Georgia</option>
<option value="HI">HI - Hawaii</option>
<option value="IA">IA - Iowa</option>
<option value="ID">ID - Idaho</option>
<option value="IL">IL - Illinois</option>
<option value="IN">IN - Indiana</option>
<option value="KS">KS - Kansas</option>
<option value="KY">KY - Kentucky</option>
<option value="LA">LA - Louisiana</option>
<option value="MA">MA - Massachusetts</option>
<option value="MD">MD - Maryland</option>
<option value="ME">ME - Maine</option>
<option value="MI">MI - Michigan</option>
<option value="MN">MN - Minnesota</option>
<option value="MO">MO - Missouri</option>
<option value="MS">MS - Mississippi</option>
<option value="MT">MT - Montana</option>
<option value="NC">NC - North Carolina</option>
<option value="ND">ND - North Dakota</option>
<option value="NE">NE - Nebraska</option>
<option value="NH">NH - New Hampshire</option>
<option value="NJ">NJ - New Jersey</option>
<option value="NM">NM - New Mexico</option>
<option value="NV">NV - Nevada</option>
<option value="NY">NY - New York</option>
<option value="OH">OH - Ohio</option>
<option value="OK">OK - Oklahoma</option>
<option value="OR">OR - Oregon</option>
<option value="PA">PA - Pennsylvania</option>
<option value="RI">RI - Rhode Island</option>
<option value="SC">SC - South Carolina</option>
<option value="SD">SD - South Dakota</option>
<option value="TN">TN - Tennessee</option>
<option value="TX">TX - Texas</option>
<option value="UT">UT - Utah</option>
<option value="VA">VA - Virginia</option>
<option value="VT">VT - Vermont</option>
<option value="WA">WA - Washington</option>
<option value="WI">WI - Wisconsin</option>
<option value="WV">WV - West Virginia</option>
<option value="WY">WY - Wyoming</option>
<option value="AS">AS - American Samoa</option>
<option value="FM">FM - Federated States of Micronesia</option>
<option value="GU">GU - Guam</option>
<option value="MH">MH - Marshall Islands</option>
<option value="MP">MP - Northern Mariana Islands</option>
<option value="PR">PR - Puerto Rico</option>
<option value="PW">PW - Palau</option>
<option value="VI">VI - Virgin Islands</option>
<option value="AA">AA - Armed Forces Americas</option>
<option value="AE">AE - Armed Forces</option>
<option value="AP">AP - Armed Forces Pacific</option>
<option value="AB">AB - Alberta</option>
<option value="BC">BC - British Columbia</option>
<option value="MB">MB - Manitoba</option>
<option value="NB">NB - New Brunswick</option>
<option value="NL">NL - Newfoundland and Labrador</option>
<option value="NS">NS - Nova Scotia</option>
<option value="NT">NT - Northwest Territories</option>
<option value="NU">NU - Nunavut</option>
<option value="ON">ON - Ontario</option>
<option value="PE">PE - Prince Edward Island</option>
<option value="QC">QC - Quebec</option>
<option value="SK">SK - Saskatchewan</option>
<option value="YT">YT - Yukon</option>
<option value="None">None</option>
</select>
<script type="text/javascript">
<!--
var comp = new ObservableComponent('employer_state', '');
comp.hide = function(_hidden) {
var _display = _hidden ? 'none' : '';
set_display('employer_state_Row', _display);
this.disable_submit_flag(_hidden);
}
//
-->
</script>
<noscript><br>Required</noscript>
</div>
</div>
<div class="form-row">
<div class="form-content" id="employer_zip_row">
<label for="employer_zip">Employer Zip:</label>
<input type="text" name="employer_zip" id="employer_zip" value="" onchange="fire_obs_comp_event('employer_zip', this);">
</div>
</div>
<div class="form-row">
<div class="form-content" id="employer_phone_row">
<label for="employer_phone_Row">Employer Phone Number:</label>
<input type="text" name="employer_phone" id="employer_phone" value="" onchange="fire_obs_comp_event('employer_phone', this);">
</div>
</div>
</div>
<input type="hidden" name="donor_matching_employersubmit" id="donor_matching_employersubmit" value="true">
<div class="button-container clearfix">
<div class="button-sub-container">
<button class="step-button action-button finish-step" type="submit" id="pstep_finish" name="pstep_finish" value="Process">Process</button>
<button class="step-button cancel-step" type="submit" id="pstep_cancel" name="pstep_cancel" value="Cancel" title="Cancel">Cancel</button>
</div>
</div>
<input type="hidden" name="idb" id="idb" value="155183574">
<input type="hidden" name="df_id" id="df_id" value="1500">
<input type="hidden" name="mfc_pref" id="mfc_pref" value="T">
<div class="form-row">
<div class="html-caption-container">
<!--<script type="text/javascript" src="//smarticon.geotrust.com/si.js"></script>-->
<br>
<style>
div.donation-level-container {
float: left;
margin-right: 20px;
}
label+div.donation-level-user-entered {
margin-left: 4px;
display: inline-block;
margin-top: 0px;
}
input[type="radio"] {
margin: 5px 0 0 0;
}
div.donation-level-input-container,
div.generic-repeat-label-checkbox-container {
padding: 0 0 10px;
}
div.responsive div.form-content {
margin-bottom: 0;
margin-right: 0;
margin-top: 0;
}
#billing_first_name_row,
#billing_middle_name_row,
#billing_last_name_row {
float: left;
margin-right: 10px;
}
#billing_addr_street1_row {
clear: both;
}
div.donation-level-input-container,
div.generic-repeat-label-checkbox-container {
padding: 0;
}
div.donation-level-user-entered {
display: block;
float: right;
margin-left: 5px;
}
div.donation-level-amount-container {
margin-top: 5px;
}
div.donation-level-label-container {
margin-top: 3px;
}
div.button-container {
border-top: 0 none;
margin-top: 0;
padding-top: 0;
}
#pstep_cancel {
display: none;
}
div.button-container {
display: inline-block;
}
div.form-row {
margin-top: 15px;
}
</style>
<!-- When on donation form -->
</div>
</div>
</div>
<input type="hidden" name="1500.donation" id="1500.donation" value="form1">
</div>
<script type="text/javascript">
var submitted = false;
function checkDoubleClick() {
var elCheck = '';
if (elCheck == 'el') {
alert('Form submission is not enabled when previewing an individual data element.');
return false;
} else if (submitted) {
alert('You have already submitted this payment. Please wait....');
return false;
} else {
submitted = true;
return true;
}
}
</script><noscript> </noscript>
</form>Text Content
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SUPPORT THE EXCELLENCE FUND The Excellence Fund at Ochsner is an unrestricted fund that is supported entirely by the generosity of our donors. Annually, teams throughout Ochsner submit applications and a committee selects projects to receive support from the fund. These projects create opportunities for improvements and innovations in patient care that are changing and saving lives every day. Since 2013, donors have helped support nearly 180 projects! In 2019, donors like you made 32 innovative projects possible! Read more about the projects that your generosity has funded since 2013. Milk Bank volunteer Susan Ginsberg and milk technician Brandy Blanchard process milk. The Milk Bank at Ochsner Baptist began from an Excellence Fund grant application submitted in 2015. 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