Social Determinants of Health Funding Request
Approved Community Health Workers should complete all the fields below to submit a funding request on behalf of their clients.
Once you enter in all of the required information and click submit, an e-mail will be sent to United Way staff to review the request.
The information is divided into four separate sections:
For additional questions, call United Way staff at 765-608-3060. If you need to submit additional supporting documents, email them to Karen Hemberger, firstname.lastname@example.org, or fax them to 765-608-3065, ATTN: Karen.