About this form

Please use this form to submit donations to the VA Desert Pacific Health Care Network.

Accepted Payment Methods:

• Bank account (ACH)
• Debit or credit card

By creating an account you can:

• See the payments you made since you created an account.
• Store payment information, such as credit card numbers, so that you do not have to reenter it each time you make a payment.
• Copy a form you already submitted so that you do not have to reenter you information next time.
• Set up automatic recurring payments (from a bank account, debit card, or credit card).

To take advantage of these benefits, you can Sign In or Create an Account . To continue as a guest user, click the 'Continue to the Form' button.