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Prisma Health Giving

Prisma Health Giving

Prisma Health Office of Philanthropy - Upstate Giving

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Home » Prisma Health Team Member Payroll Deduction Authorization Form

Prisma Health Team Member Payroll Deduction Authorization Form

Please complete this form to authorize payroll deductions. Anticipated start of deductions is within the next three pay periods.

For more information, please contact Cyndie Ford, Office of Philanthropy, by phone at 864-797-7744 or by email at Cynthia.Ford@prismahealth.org.

Prisma Health Employee Payroll Deduction Authorization Form

Personal Information

Name *
Name
First
Last
Address
Street Address
Street Address 2
City
State/Province
Zip/Postal

Work Information

If you are on the Prisma Health Network, find your Employee ID Number Here. If you are not on the network, your Employee ID Number can be found on Workday under your “Job Details” page.

Donation Information

Medical Education & Workforce Development
Psychiatry
Bradshaw Institute for Community Child Health & Advocacy
Cancer Institute
Children’s Hospital-Upstate
Heart & Vascular Services
Neuroscience Institute
Nursing
Roger C. Peace Rehabilitation Hospital
Women’s Services
The Canine F.E.T.C.H. Unit
Community Health
$
1

$

$

Signature

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If you’d like more information about supporting the Prisma Health Office of Philanthropy, please contact the office at 864-797-7746 or giving@prismahealth.org.

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Copyright © 2023 Prisma Health
Prisma Health is a registered 501(c)3 organization. Prisma Health-Upstate tax identification number is: 81-1723202
You can stop your monthly giving at any time. Call us a (864) 797-7746 or send us an email at Giving@PrismaHealth.org to change or cancel your monthly pledge.