Californians for Patient Access

The mission of the APA is to ensure that all personal injury victims have access to immediate, quality, necessary medical care, regardless of their ability to pay.

Due to the false narratives advanced by the insurance lobby and others, the California legislature is considering legislation that will limit personal injury patients’ access to medical care and limit a providers' ability to sell their account receivables.

We need your help to fight this legislation! You can donate here, join APA as a full member, and sign-up to testify on specific issues and meet with your legislators. All donations received through this fundraiser will be used to directly pay for APA’s legislative initiatives in California – fighting on behalf of personal injury patients and their medical providers.

If you have any questions, please contact APA at jill@c2cpro.solutions.

Information

Personal Info

Name

On behalf of business

Business Name

Already Have An Account?

User Name

Password

Logged In As {{Environment.CurrentUserData.DisplayName}}

Gift Details

{{Environment.PledgeItems.length>1?"Select Type" : "Type"}} Suggested Amount Gift Amount Frequency Start Date End Date Total
{{itemPledgeItems.Description}} (Minimum Amount: {{itemPledgeItems.ExtraOptions.MinimumPrice \| currency}}) Suggested Amount {{itemPledgeItems.SuggestedPrice \| currency}} Gift Amount The minimum amount is {{itemPledgeItems.ExtraOptions.MinimumPrice \| currency}} The maximum amount is {{itemPledgeItems.ExtraOptions.MaximumPrice \| currency}} Please enter Suggested Amount only. Frequency Start Date End Date The max end date is {{formattedMaxEndDate(itemPledgeItems)}}. Total
Total Amount Today

Suggested Amount

Gift Amount

Frequency

Start Date

End Date

Total

{{itemPledgeItems.Description}}
(Minimum Amount: {{itemPledgeItems.ExtraOptions.MinimumPrice | currency}})

Suggested Amount {{itemPledgeItems.SuggestedPrice | currency}}

Gift Amount

The minimum amount is {{itemPledgeItems.ExtraOptions.MinimumPrice | currency}} The maximum amount is {{itemPledgeItems.ExtraOptions.MaximumPrice | currency}} Please enter Suggested Amount only.

Frequency

Start Date

End Date

The max end date is {{formattedMaxEndDate(itemPledgeItems)}}.

Total

Total Amount Today

Address

Address 2

City

State/Province

Postal Code

Country

Additional Information

Message

Tribute/On Behalf Of

Recognition Name

{{cfv.DisplayName}} {{[1, 2].indexOf(cfv.CustomFieldDataTypeId) >= 0 && cfv.DataSize > 0 ? (" (Max length: " + cfv.DataSize + ")") : ""}}

Payment Processing

Payment Amount Pay by Invoice
Please ensure all fields on the form are filled out correctly