Locations

Jackson Hospital
1725 Pine St.
Montgomery, AL 36106
Map and driving directions

The Jackson Clinic and Urgent Care-Montgomery
1801 Pine St.
Montgomery, AL 36106
Map and driving directions

The Jackson Clinic and Urgent Care-Montgomery
4150 B Carmichael Road
Montgomery, AL 36106
Map and driving directions

The Jackson Clinic and Urgent Care-Pike Road
11123 Chantilly Parkway
Pike Road, AL 36064
Map and driving directions

The Jackson Clinic-Prattville
701 & 703 McQueen Smith Road
Prattville, AL 36066
Map and driving directions

Jackson Imaging Center
1825 Park Place
Montgomery, AL 36106
Map and driving directions

Jackson Surgery Center
1725 Park Place
Montgomery, AL 36106
Map and driving directions

The Jackson Clinic Locations

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Form

Donate Online

Welcome to the Touchstone Society Online Giving Form

The Touchstone Society is a unique VIP donor club that provides benefits as a way of showing appreciation to special friends and contributors to the Jackson Hospital Foundation.

Membership is on an annual basis. Benefits apply to the various levels of giving, to learn more about the levels and their benefits, click here.

Prefix:

*First name:

*Last name:

*Street Address:

*City:

*State:

*Zip Code:

*Telephone:

*Email:

Desired level of giving:

Friend ($100–$249) Associate ($250–$499) Patron ($500–$999) Benefactor ($1,000–$2,999) Heritage ($3000+)

*Total amount you wish to donate (Example 150.00):

I do not wish to join the Touchstone Society at this time, but I would like to make a tax-deductible donation.

Payment Information

*First name on card:

*Last name on card:

*Payment type:

*Credit card number (no spaces or dashes):

*Expiration Month

*Expiration Year:

*Billing Street Address:

*City:

*State:

*Zip:

*What prompted you to donate?

If other, please explain:

In Memory of:

In Honor of:

Name and address of person you would like notified of your gift:

Additional comments:

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