Cardiac Rehabilitation Enhancement Requests

Please read before completing your application below:

Project Scope: The funding request must be for a project that directly enhances the cardiac rehabilitation environment for patients.
Team Requirement: The application must be submitted by a recognised cardiac rehabilitation team.
Funding Requirement: Applicants must agree to actively participate in fundraising activities to contribute to their allocated funding pot.
Cost Estimates: Applicants must provide detailed cost estimates for the proposed project or items. They are responsible for finding and providing the best possible prices for any items.
Alignment with Objectives: The project must align with the Sussex Heart Charity’s objectives and values.
Trial Stage: Applicants must acknowledge that this project is in a pilot stage and are willing to participate in any required evaluations or feedback processes.
Maximum Request Limit: There is a maximum request limit of £500 per request.

Your Details

Title *

First Name *

Last Name *

Job Title *

Your Email Address *

Contact Phone number *

Which hospital do you work from? *

How much are you requesting? *

All prices to be inclusive of VAT

What are you requesting? *

Please provide a short but accurate description of any items and links to suppliers. (Medical suppliers, Amazon, Argos etc...)

What equipment or resources are you currently using to meet this need? *

If successful, how will this request enhance cardiac rehabilitation? *

How will this equipment/item directly benefit patient care or outcomes? *

Please be specific about the improvements it will help achieve (e.g., physical health, recovery times, quality of life).

Briefly explain any specific challenges or limitations have you encountered with other funding streams that prompted you to seek support from the Sussex Heart Charity? *

Delivery address *

If successful where would you like the item(s) delivered?

Apt, suite, etc.

Country

City

Zip code

Declaration

I have read and understood the eligibility criteria and guidelines outlined above this form.
I declare that the information provided in this application is accurate and truthful.
I confirm that I have fully completed this application form and have attached detailed cost estimates.
I understand that the award of funding is at the sole discretion of the Sussex Heart Charity and that meeting the eligibility criteria does not guarantee funding.
I agree to abide by the conditions set forth by the Sussex Heart Charity in relation to this funding award.
I agree to actively participate in fundraising efforts to contribute to the sustainability of our allocated funding pot.
I acknowledge that a portion of the funds raised will be allocated to the Sussex Heart Charity general fund, with the remaining funds directed to our respective project pot.
I understand that failure to comply with the terms and conditions may result in the withdrawal of funding support.
I acknowledge that this project is in a trial stage and agree to participate in any evaluations or feedback processes required by the Sussex Heart Charity.

Check to confirm and submit your application *

I AGREE

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