FOR A CONFIDENTIAL ADMISSIONS ASSESSMENT

If you or a loved one would like to speak directly with one of our licensed admissions staff, please call us now at (800) 646-9998 or submit the following information. If outside business hours, we will get back to you the following day.

* Required Field

1. How may we help you?*
Who is this contact about?*
- Myself
- A Loved One
2. Please provide your full name*
First Last
3. Please provide your date of birth
MM
DD
YYYY
4. Please provide your email address*
5. Please provide the best number to reach you*
6. Please provide your loved ones full name*
First Last
7. Please provide your loved ones date of birth
MM
DD
YYYY
May we contact your loved one?*
- Yes
- No
8. Please provide a number to reach your loved one
May we leave a voicemail or send an email identifying ourselves as Cumberland Heights?*
- Yes
- No
Please briefly describe the situation (include any insurance info, drug of choice, frequency of use)*
Please provide your question or comment below*

Why is it so meaningful to give to Cumberland Heights?

Your gift to Cumberland Heights through our annual and capital initiates gives immediate support to patients and their families. To make a longer term impact a gift to the endowment fund will provide patient assistance funding for years to come.

Reaching New Heights Women’s Luncheon Donation

Donate to the Reaching New Heights Women’s Luncheon

STEP 1 - Donation Type: Reaching New Heights Women's Luncheon

STEP 2 - Your Personal Information

STEP 3 - Additional Options

Acknowledgement Card

STEP 4 - Credit Card and Billing Information

STEP 5 - Confirm Donation Total

Total Donation Amount:

Signup For Emails

Please leave this field empty

Great, we're glad to have you on board with us! Check your inbox or spam folder now to confirm your subscription.

Local Line

Admissions Line

CUMBERLAND HEIGHTS IS PROUDLY ACCREDITED BY OR PARTNERED WITH:

FOR A CONFIDENTIAL ADMISSIONS ASSESSMENT

Why is it so meaningful to give to Cumberland Heights?