FMOLHS logo
ServicesFind a Doctor
Locations
Patients & Guests
Research and Education

Our Lady of the Lourdes Health Community Benefit Applications

Community Benefit Applications

Please review our mission and vision before submitting an application for community benefits.


 

Based on our most recent CHNA, we invest in these key areas:

  1. Access to Primary Care
  2. Cancer
  3. Women, Maternal and Child Health
  4. Health Disparities (Social Determinants of Health)

Required Forms

These are forms that are required to fill out and upload in your Community Benefits Application below.

Ownership Acknowledgement Form

Before filling out the application below, Download, fill, and save this Ownership Acknowledgement Form. It must be submitted as part of the application below.

Supplier Supplement Form

Before filling out the application below, Download, fill, and save this Supplier Supplement Form. It must be submitted as part of the application below.