US Eye Better Together Employee Relief Fund Pledge Form

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We are devastated to learn of the effects of Hurricane Ian, especially how it has impacted our US Eye employees in Southwest Florida. We hope to provide our team members with some relief during this time in the form of cash grants that they can use to for evacuation and long-term recovery expenses as they begin to rebuild.

US Eye will match all donations dollar for dollar up to $50,000 and our Founder and CEO, Dr. Shoemaker has generously agreed to personally match an additional $25,000.

Please consider pledging any amount to help us aid our employees during this unprecedented time. There are several immediate ways to donate - including ACH, check and through a donor advised fund. Credit card donations will be available in the coming days. All contributions to the fund create an immediate tax deduction and will be used to support US Eye employees in need today and in the future.

Your Full Name *

Your Email *

Your Phone Number *

I pledge to donate the following amount to the US Eye Better Together Employee Relief Fund: *

$ 50

$ 100

$ 250

$500

$1,000

Other:

Please select your Donation Method *

ACH Payment (instructions will be sent to you upon receipt of your pledge)

Check - Payable to E4E Relief, PO Box 896796, Charlotte, NC 28289-6796

Donor Advised Fund Contribution

Credit Card (this will be available soon through our donation website)

Do you wish to remain anonymous? *

Yes

No, you may publish my name and donation amount.

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