Legacy Employee Assistance Fund - Payroll Deduction

Use the below form to make a donation by payroll deduction.

If you would like to make a donation by credit card, please click here.

If you would like to make a donation through our printable form, please click here.

If you are a Legacy employee and you need assistance, complete the application and submit to leaf@legacycommunityhealth.org. Limit one application per household.

If you need assistance completing this form, email leaf@legacycommunityhealth.org .