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Request Hospital Support

Hospital administrators, medical officers and authorized staff can request infrastructure assistance — sanitation and washrooms, patient wards, drinking water, waiting areas, ambulances, nutrition and other hospital needs.

What happens after you submit: our team reviews every request, may contact you for more information, and conducts a joint need assessment with hospital authorities before a project is approved and scoped.

Please note: submission does not guarantee acceptance or funding. Your contact information is kept private and used only to process this request.

Please do not upload patient medical records or patient-identifiable information. This form is for infrastructure needs only.

  1. Hospital
  2. Requester
  3. Assistance
  4. Evidence
  5. Consent
Hospital Information