Donations

Donation Form

Thank you for your support! Your donation to The REACH Institute will provide evidence-based mental health care to children who otherwise might go undiagnosed and untreated.

Your tax-deductible donation will help to:

Train pediatric providers to provide evidence-based mental health care rather than referring families to specialty services they might or might not be able to access

Fund scholarships for providers serving children in under-resourced communities

Support ongoing program development

Donor Information

First Name

Last Name

Phone

How did you hear about REACH?

Name of Friend / Colleague

If other, please specify how you heard about REACH

Donation Information

Donation Amount

The Donation has to be $25 or more in value

Cover Transaction Costs?
I want to help even more by covering the 2.25% transaction fee on my donation

YesNo

Total Amount

Dedicate this donation

Honoree Name(s):

I prefer to remain anonymous

Payment Information

Name on Card

Card Number

Code

Billing Email

Billing Country

Billing Street Address

Billing City

Billing State/Province

Billing Zip/Postal Code

Contact Information

Donations

Donations

Donation Form

Register for courses

Akilah Cook, MD
Appleton, WI

Donations

Donation Form

Register for courses

Akilah Cook, MD Appleton, WI

Akilah Cook, MD
Appleton, WI