Thank you very much for your generous donation! Your support will allow this film be the best that it can be and help us to reach an even larger audience.

Please do the following:

1. Fill out this submission form so that we can process your gift as a tax deductible donation through our fiscal sponsor, the Utah Film Center.

2. Mail a check or wire the funds to:

For checks, please make it out to UTAH FILM CENTER (***earmarked Undiagnosed in the memo) and mail to:

PO Box 682957

Park City, UT, 84068


For wire transfers, please contact:

Mario Herbst at 801-746-7000 or accounting[at]

*Be sure to notate that your donation is for Undiagnosed

Name *
If you are sending a check, please mail to: Utah Film Center Attn: Fiscal Sponsorship, Undiagnosed 122 South Main Street Salt Lake City, Utah 84101 For wire transfers, please contact contact Mario Herbst at 801-746-7000 or accounting[at]