Request Support

Dedicated to benefitting health

Roche is proud to support meaningful health initiatives and organisations in our community. We want to ensure that the support we give has the greatest possible impact and is provided in accordance with the Roche Pharma Directive on Grants, Sponsorships and Donations and legal requirements. We have put a process in place to make sure this happens. In order to request support, healthcare organisations and patient organisations must complete the form below.  Below is a guide to help make the process smoother.

Request Support

Please note that failure to complete this form fully with all necessary information will delay the assessment of your request.

 

PLEASE NOTE the below:

  • Roche only supports healthcare initiatives. Roche is unable to support salaries or equipment. 
  • Please ensure that your request is for a specific campaign, initiative, event or item. Roche is unable to give a support towards general/core funding.

 

Guidance for filling out the form:

  • If approved, support from Roche is always transferred to the healthcare organisation, not to the individual healthcare professional. 
  • All support is given to campaigns, initiatives and events that benefit patients and/or public health. Ensure that you highlight how your request does this. 
  • Applications from Patient Organisations are invited during a set time period at the end of each year in advance of the following year.

 

Roche Support Request Form

Applicant Details
All requests for support received can expect a decision by the end of the following month (e.g. if a request is received on 15th February, a response will be communicated by 31st March)
 

Institution (Hospital/Practice/Organisation) Details

Contact Person Details

Support Request Details

50 characters left

Funding and Payment Details

Please note, funding can only be transferred into an account of the institution submitting the request for support

By submitting this request, I agree that if my request is approved, I will provide evidence that the support was used for that stated purpose. 

 

* fields marked with asterisk are required