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Leave a Legacy in the New UPMC Hamot Patient Tower

Dedicate a Patient Room — Only $38 Per Pay

ICU Room Template Board

With the new patient tower nearing completion, Hamot Health Foundation is honored to offer a special naming opportunity to all employees of UPMC Hamot.

Employee donors are able to dedicate a patient room to honor their family, memorialize a loved one, or recognize others who have impacted their life, their health, or their career. A custom storyboard placed near the room will provide an opportunity to share the story of those recognized.

Fields marked with are required.

Payroll Deduction Request Form

Note: Giving by payroll deduction is only available to employees of UPMC Hamot

Giving option examples:

  • A $3,000 pledge, paid over 3 years, 26 annual pay periods = $38.47 deduction per pay
  • A $3,000 pledge, paid over 1 year, 12 annual pay periods = $250 deduction per pay
  • A $7,500 pledge, paid over 2 years, 12 annual pay periods = $312.50 deduction payroll
Please choose a pledge size.
Please choose which level you prefer.
A representative of Hamot Health Foundation will contact you to coordinate details of your recognition opportunity.

Authorization

By submitting this form, I understand that I am pledging philanthropic support to Hamot Health Foundation. I authorize the necessary amount to be automatically deducted from my pay each pay period to fulfill my total pledge in the amount of time selected above.