I/We invest in today, tomorrow, and hope!

It’s your Institute. It’s our Institute. Our Parkinson’s Institute and Clinical Center depends on us. We’re in this together.

Jim and Guila Pollock
Living with Parkinson’s disease

Caring for people with a disease as complex as Parkinson’s does not fit neatly into today’s healthcare economics. It takes much more than an assembly line approach and a 15 minute consultation to provide appropriate and impactful care. Financial support from people living with Parkinson’s and their loved ones, people like you, ensure that no sacrifice is made and no corner is cut.

Government and foundation research grants only cover a modest portion of the expenses associated with your Institute’s remarkable science. Philanthropy drives the pace at which our Clinical and Laboratory Researchers are able to pursue their work. How quickly do we want access to new and better treatments? How badly do we crave discoveries that one day, hopefully, will lead us to a cure?

Go beyond “giving back.” Support your Institute—our Institute—graciously, generously, and to the fullest extent that you can.

We thank you from the bottom of our hearts.

Parkinson’s Institute and Clinical Center is a 501(c)(3) non-profit organization. Tax ID 94-3061594.  All transactions conducted on our website are encrypted using a secure server to protect your privacy. Please complete all the fields on the form below and click submit. If we have any questions about your donation we will contact you. If you have any questions or concerns about making an online donation, please feel free to call us at 408-542-5676. If you are having trouble completing this form, please click here.

I want to make a donation of:

Amount $25 or more (no '$' sign or ',')*


 Mr.  Mrs.  Ms.  Mr. & Mrs.  Dr.
First Name *
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Address 2
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Fax Number
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Yes, I would like to receive communications from the Parkinson's Institute
Anonymous Donation

Billing Information

Name of Cardholder *
(as it appears on the card with no period following initials)
Credit Card Number *
Expiration Date *
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C V V code is the 3 digit security code on the back of your Visa or Master Card.
America Express has a 4 digit code on the front.


This gift is
 General Donation  Memorial Gift  Honorary Gift
 2019 More Talk! More Walk!  
Does your company have a Matching Gift Program?
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(see below)

A Memorial Gift is a donation in memory of a loved one or friend. An Honorary Gift is a donation to celebrate a special occasion (for example: a holiday, a birthday, an anniversary, or a wedding), or recognize the courage of a loved one or friend who is living with Parkinson’s disease.

Please enter the name of the person for this Tribute.

 Mr.  Mrs.  Ms  Dr.

When a memorial or honorary gift is received, the Parkinson’s Institute will promptly send a personalized tribute card to the person or family indicated, notifying them of your thoughtful donation.  Please note that we will not disclose the amount of your donation.

Please enter the name and address for the person(s) you wish to receive a tribute card.

 Mr.  Mrs.  Ms.  Mr. & Mrs.  Dr.
Full Name
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Additional Information:


Many companies offer employees a matching gift benefit that increases your gift to the Parkinson's Institute. If your company has a Matching Gift Program, please obtain the proper matching gift form from your company and send your completed matching gift form to:

Parkinson’s Institute and Clinical Center
2500 Hospital Drive, Building 10 Suite 1
Mountain View, CA 94040

Click here to view the Parkinson's Institute's privacy policy. Contributions are tax-deductible to the extent permitted by law.

If you have any questions or concerns about making an online donation, please feel free to call us at 408-542-5662.

If you are having problems completing our donation form, here are some tips:

Dollar amount is entered without commas or dollar signs.  Decimals are ok.  For example, a $1,500.50 donation should be typed in as "1500.50" without any comma or dollar sign.

Name of Card Holder is entered exactly as it appears on the credit card.  Do not include any special characters or punctuation.  

For example, Mary J. Doe should be typed in as "Mary J Doe" without any puncuation.  Mary J. O'Hare should be typed in as "Mary J OHare".  Mary Jane O'Hare-Doe should be typed in as "Mary Jane OHareDoe" or "Mary Jane OHare Doe".  If this box contains any punctuation or special characters, you will receive a "Card holder name error" message.

Donor Zip/Postal Code must match the billing address zip code on file with the credit card company .

C V V Code must match the code on the card.  Be sure you are entering the correct code, based on the type of card you are using. For Visa and MasterCard, the code is the 3 digit code on the back of your card.  American Express has a 4 digit code located in the upper right corner on the front of the card. 

Asterisked (*)  Boxes are required information and all must be completed in order for your form to be accepted.

Please Note:  For security purposes, you must type the text you see in the picture below into the box below the picture to complete this form.

For more help please do not hesitate to contact us at (650) 770-0201.  Your donation is important to us.

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2500 Hospital Drive, Bldg #10, Suite 1 | Mountain View, CA 94040
650.770.0201 main | 650.770.0204 fax (Clinic Secure)