Gift In-Kind Survey

UnityPoint Clinic - Express

180 Jordan Creek Parkway, Suite 120
West Des Moines, Iowa 50266

00 Patients
Waiting Now

UnityPoint Clinic Urgent Care - Altoona

2720 8th St. SW
Altoona, Iowa 50009

05 Patients
Waiting Now

UnityPoint Clinic Urgent Care - Ingersoll

2103 Ingersoll Ave., Ste. 2
Des Moines, Iowa 50312

04 Patients
Waiting Now

Urgent Care - Ankeny

3625 N. Ankeny Blvd.
Suite E
Ankeny, Iowa 50023

01 Patients
Waiting Now

Urgent Care - Lakeview

6000 University Avenue
Suite 101
West Des Moines, Iowa 50266

03 Patients
Waiting Now

Urgent Care - Merle Hay

4020 Merle Hay Road
Suite 100
Des Moines, Iowa 50310

06 Patients
Waiting Now

Urgent Care - Southglen

6520 SE 14th St.
Des Moines, Iowa 50320

06 Patients
Waiting Now

Urgent Care - Urbandale

2901 86th Street
Urbandale, Iowa 50322

02 Patients
Waiting Now

Gift In-Kind Form

Thank you for your generous gift to John Stoddard Cancer Center. Please complete the form below to the best of your ability. Information listed will be utilized for tax purposes. 


1: Name of Organization (if applicable)
2: First Name
3: Last Name
4: Parent or Guardian (if donor is under 18 years of age)
5: Street Address
6: City
7: State
8: Zip
9: Phone
10: Email
11: Description of Items Donated
12: Number of Individuals Involved
13: Approximate Number of Hours Contributed
14: Estimated Fair Market Value of Donation
15: I would like to make this gift in honor of:
16: I would like to make this gift in memory of:
17: What inspired you to support John Stoddard Cancer Center?