DBSA Legacy of Wellness Society donors leave a legacy that provides hope, help, support, education, and life. Your planned gift will improve the lives of people who live with mood disorders―today, tomorrow, and far into the future. Your information will be confidential and you have the option to keep your membership anonymous.

Thank you for your lasting commitment to improving the lives of people living with mood disorders!

All information fields below are required and should be marked with an asterisk* unless noted as optional.

Your Information

We value your privacy and will not share your personal information.

Yes, I would like to receive e-mail from Depression and Bipolar Support Alliance

Spousal Information

Please tell us how you would like to be recognized.

You may recognize my/our gift by including my/our name(s) on the DBSA Legacy of Wellness Virtual Donor Wall.I/we wish my/our contribution to remain anonymous.

If you'd like to be recognized on the DBSA Legacy of Wellness Virtual Donor Wall, please list how you want your name(s) to appear.

Beneficiary Information

Will/trustCharitable trustAnnuityLife insuranceIRA or retirement planOther

Attorney’s Contact Information

Questions or Comments

I/we have some additional questions. Please have a gift planning officer contact me.No, I do not require a follow-up phone call.

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