Funding Application Forms
Founded in 1873, St. Patrick Hospital’s mission is to care for all people, especially the poor and vulnerable through our compassionate service. The Providence Montana Health Foundation exists to promote and provide access to the best possible health care and human services for those who live, work, or play in Western Montana.
General Funding Application
The General Fund provides assistance in a variety of ways, including:
- St. Patrick Hospital capital requests.
- Assistance with medical bills for patients who do not qualify for the Cancer Compassion Fund.
- Help paying for fuel to travel to and from frequent treatments, such as cardiac rehab or dialysis appointments.
- Payment assistance for medical work before a procedure can be completed; for example, required dental work prior to cardiac surgery.
We support investments in medical equipment and facilities, clinical and basic medical research, and help bring resources to rural health care facilities and medical providers in Western Montana. We also provide health care-related financial assistance to individuals in need.
Direct beneficiaries of our fundraising efforts include: St. Patrick Hospital, the Montana Cancer Center, St. Joseph Medical Center, St. Patrick House, the Montana Neuroscience Institute, the International Heart Institute and many others.
Criteria for requests include:
- Consistent with Mission of St. Patrick Hospital or St. Joseph Medical Center
- Focus is on improving health
- May be a collaborative effort with other providers/organizations
- Is able to be completed at a reasonable cost, mindful that these dollars come from the generosity of others
- Is logistically feasible
Download a Providence Montana Health Foundation General Fund Application Form
Due to the volume of requests we receive, we are not able to honor every appeal. If your request is approved, we will respond within 60 days of receipt of your request.
Team Up Montana Funding Application
Team Up Montana is a dedicated effort to raise awareness and funding for the fight against cancer in Western Montana. Our efforts are guided by our core values of Respect, Compassion, Justice, Excellence and Stewardship.
Apply for funding assistance from Team Up Montana if you need help:
- Paying for utility bills, everyday expenses or fuel to travel to and from treatment.
- Providing lodging for a husband while his wife undergoes radiation away from home.
- Paying medical bills for treatment and surgery.
- Getting a voucher for preventative screenings, such as mammograms.
Criteria for requests include:
- The request is in accordance with the St. Patrick Hospital Foundation’s mission.
- Individual must be a current patient undergoing, or who has recently completed, cancer treatment.
- Individual must live in Western Montana.
- Individual’s medical status must be confirmed by a health care professional.
- Funds are limited and grants are based upon availability of funds and the applicant’s need.
- Request is of a reasonable cost, mindful that these dollars come from our patients and community and are not to be considered as an on-going source of funds.
Download a Team Up Montana Funding Application Form
Please be sure to:
- Answer each question or indicate if an item does not apply to your situation.
- Have your doctor, nurse, or social worker help you complete the Medical Information section if needed.
- Provide a phone number where you can reached to answer any additional questions.
Due to the volume of requests we receive, not all submissions will be honored. Therefore, completion of this request form does not obligate Team Up Montana or the Providence St. Patrick Hospital Foundation in any manner.
Approval of a request represents a one-time assistance payment and does not in any way constitute a promise of future financial assistance. All information is held in the strictest confidence and is used only for the purpose of reviewing financial assistance needs.