At Medical City Healthcare, we are committed to the care and improvement of human life. We are also committed to involvement in the communities we serve.

If you would like to request support from Medical City Healthcare, please fill out the form below. For support from one of our hospitals on behalf of your organization, please select a link below, fill out the form and a representative will contact you.

Type of Request:


If Tax-Exempt, Please Include:

General Internet communication is inherently not secure. For this reason, we highly recommend that data considered confidential or private in nature not be submitted on this form. (e.g., Social Security Numbers, Diagnosis Information, Credit Card Numbers, etc.)