Funding Applications

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.

Application forms

Criteria for the General Foundation and Team Up Montana funds are listed below. If you are not sure which application you should use, please call 406-329-5640.

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.

General medical funding application

The General Medical Fund provides assistance in a variety of ways, including:

  • Assistance with medical bills for Providence St. Patrick Hospital or Providence St. Joseph Medical Center patients who do not qualify for the Team Up Montana Cancer Compassion Fund.
  • Help paying for fuel to travel to and from frequent treatments, such as cardiac rehabilitation appointments.
  • Payment assistance for medical work before a procedure can be completed; for example, required dental work prior to cardiac surgery.

Direct beneficiaries of our fundraising efforts include Providence St. Patrick Hospital, the Montana Cancer Center, Providence St. Joseph Medical Center, St. Patrick House, 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

Please be mindful that these dollars come from the generosity of others, and that your request Is logistically feasible.

General Medical Fund Application Form

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.

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.

Team Up Montana Fund Request Form