Patients’ Fund Application Form
Before completing this form, please ensure you have read the funding guidelines.
If you need any help with this form, you can contact the team
The compulsory fields, marked with a res asterisk, are necessary so the Charity has enough information available to evaluate your project. Please complete one application form for each project, idea or item/equipment required.
On the ‘Funding’ section of the form, we ask you to upload a project budget. If you wish, you can use RBH Charity’s project budget form template, or you may prefer your own format. Please ensure that quotes include VAT, when applicable, delivery costs and any necessary building, installation and maintenance costs.
Just a reminder that you can apply for medical equipment that costs up to £5,000. For equipment above this amount, please apply to the Medical Equipment Fund. For more information, contact Benoush Tavana – Medical Equipment Programme Manager.
In submitting this form, you confirm you agree to the use of personal data according to the Charity’s Data Privacy Statement. Please ensure you have read and understood the statement before submitting this form.
The deadline for completing this form is Thursday 13 November 2025.