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Fondation Cite De La Sante

Fondation Cite De La Sante, Laval,QC Vehicle Donation Quotation Form

Fondation Cite de la Sante focuses on improving the quality of the care and the services provided to the patients of the Cite-de-la-Sante Hospital and the Health and Social Services Centre (CSSS) of Laval with the purchase of high technology medical equipment. It also promotes knowledge acquisition pertaining to the health field and supports research in general and specialized care while contributing freely to the quality of life of the patients.

Vehicle Donation Quotation Form

Please note: By filling out the form below you are not committed to donating your car. Filling out this form will allow us to contact you with a quote on the price the charity of your choice will receive for your vehicle. All personal data is kept strictly private and will never be sold.
Owner Information Section
Name * State/Province *
Address on Ownership * ZIP/Postal Code *
City *
Daytime Phone Number * Phone/Cell/Work Number *
Email *

Donating Your vehicle?

Yes, I want to donate my vehicle to Fondation Cite De La Sante.

Vehicle Information Section

Year * Make *
Model * Mileage
License Plate VIN #
 If your vehicle is located at a different address from your home address, please check the box and then complete the following section, if same as home address (skip)
Condition of vehicle Comments about vehicle
I do have the ownership / title to transfer to the Authorized Treatment Facility.

Vehicle Images Section
Uploading images will help us to better determine the value of your vehicle, possibly increasing what we will pay for your car.

Human? Answer this question 4+7=