Donation Request Form | UnityPoint Health Grinnell Regional Medical Ce
A child being held by grandpa and kissed by grandma

Community Contribution Requests

UnityPoint Health – Grinnell Regional Medical Center is proud to support non-profit organizations in the communities we serve. As a not-for-profit health care organization, we believe in the value of giving back. Our donations focus on supporting organizations that are consistent with the mission of the medical center. Priority is given to organizations that assist people in crisis, focus on health promotion, education, civic and community issues and contribute positively to the community's quality of life. 

We have developed guidelines for requests for sponsorships, cash contributions and in-kind donations to ensure that the support from UnityPoint Health – Grinnell Regional Medical Center is appropriate and consistent with our mission – to improve the health of our community . 

We request that all organizations seeking a contribution complete the Community Contribution Form below. Requests will be reviewed and awarded on a quarterly basis. If your request is not granted, it can be rolled over to the next quarter without the need to re-submit the paperwork. Notification will be sent by email or mail to all organizations submitting a request for the quarter. 

Please be aware that our contributions will NOT:
•         Be awarded to for-profit organizations 
•         Be used toward an endowment fund 
•         Fund general operating expenses of an organization 
•         Fund a political campaign or candidate for elected public office 
•         Fund an individual

If you would like GRMC to consider a request for sponsorship, donation, event participation or contribution, please complete the form below. Applicants will receive an email notification regarding their request within two to four weeks.


Community Contribution Form








Request for (Please Select One):

 Event/Project Name: Date Contribution is Needed (mm/dd/yyyy): Project/Event Purpose of Request: Recognition/Benefit Available to GRMC: Expected Reach of Project: Organization InformationName of Organization:Address: City: State Zip Code: Contact Name: Affiliation with Group: Daytime Phone Number: E-Mail: Mission/Purpose of Your Organization: