Donate to PHM Collection

Thank you for your interest in donating an item to the Public Health Museum!
Below is the form that needs to be filled out for each item that you wish to donate.
Please note, not all items submitted will be accepted. Our collections team at the museum will review your submission and will be in touch.
If you have any questions or are having any trouble, please do not hesitate to contact us.

Donations to the Museum

Please fill out form below for each item that you wish to donate.

Contact Information

* Indicates required field

Name *

First

Last

Email *

Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Object Information

Please describe the item you would like to donate to the museum *

Object Condition *

Object Ownership Information

Ownership: Are you the sole owner of the object, and do you have full power of authority to transfer it to the Public Health Museum? *

Yes No

Please provide any and all information associated with the object, such as people, dates, previous owners, or previous events. *

How did you become the owner of this item, and how long have you owned it? *

Images/Documents
Please submit any photos or documentation that you have in regards to the object.

Upload File *

Max file size: 20MB

Submit

Donate Items to the Public Health Museum Collection

Donations to the Museum