Share your why

What motivates your support?

Our life-saving grants would not be possible without you! With so many important causes out there, we’d love to hear why you chose to help people access their critical medications.

Your reason for donating to PAN can inspire others to join us in raising additional funds for patients in need. Please fill out the form below to help us grow our community of caring supporters like you.

Here are a few questions to start

Share as much or as little as you like. You can even attach photos and videos below to help us form a deeper connection with your responses.

Testimonials and consent from individual donors

Step 1 of 2

Full name*
Email*
State*
Have you or someone you know received assistance from PAN?*
- Yes
- No
What motivated your gift to PAN?*
Why should others donate to PAN?*

Why does financial assistance for patients matter to you?
Here’s a fun question! You’re a hero to us. What’s your superpower?
What else would you like us to know?
If you would like to include photos or videos with your responses, please upload them in the box below.
Drop files here or

Accepted file types: jpg, gif, png, jpeg, mp4, mov, Max. file size: 50 MB, Max. files: 6.
Size limit for each file is 50 MB; maximum of 6 files.
Please consent to our Terms and Conditions

Please read this carefully before you share your story and any personal information or media with us. By submitting information to the PAN Foundation and clicking “I agree,” you’re confirming that you have read, understand, and agree to the PAN Foundation’s Terms and Conditions as follows:
- You understand and agree that we may use your content for any informational, fundraising, or promotional purposes.
- You understand and agree that we can use and display any of your content and personal information that you provide in any format.
- You give us the right to verify the information you submit with other information we may have in our files.
- You give us the right to contact you for additional information if we think it would be helpful or necessary to do so.
- You understand and agree that you will not be paid or reimbursed in any way for your content or other information you provide to us.
- You consent to the use, distribution, and redistribution of your content and information by the PAN Foundation and its employees, contractors, and representatives.
- You understand and agree that you do not have the right to inspect or approve any finished product.
- You release and agree to indemnify and hold harmless the PAN Foundation, its employees, contractors, and representatives from any claims, lawsuits, injury and/or damages as a result of the content and information you provide to us.
This includes but is not limited to claims for personal injury (including injury to reputation), property damage, invasion of privacy and/or breach of confidentiality.
Download our Terms and Conditions (PDF 230KB)
I am interested in future opportunities to share my story with the PAN community.
Consent*
I agree with your terms and conditions*
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What motivates your support?

Here are a few questions to start

Testimonials and consent from individual donors

Step 1 of 2

Please consent to our Terms and Conditions