Feminist Health Fund Application Request
The Feminist Health Fund is a non-profit group that provides assistance to women for health related expenses during times of financial hardship. Please use this application to make a financial assistance request. All other inquiries please contact us at info@feministhealthfund.org.

If you need assistance filling out this form please give us a call at (937) 767- 8949
Email *
Name *
Age *
Phone Number *
Current Ohio County of Residence *
Current City of Residence *
Please briefly explain the type of assistance you are seeking *
Please briefly explain your current financial situation *
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