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We’re so glad you’re here—and grateful for your interest in bringing your community together to uplift trans voices and experiences in healthcare.

We’re so glad you’re here—and grateful for your interest in bringing your community together to uplift trans voices and experiences in healthcare.

This intake form is for small nonprofits and grassroots groups who want to host a gathering where folks can take the Trans Health Survey together in a safe, welcoming space. To support your efforts, your group may be eligible for a $50 gift card to help offset the cost of food or refreshments during your event. Please note: Filling out this form does not guarantee funding. At this time, this opportunity is available only to 501(c)(3) organizations or community groups with an annual budget of $100,000 or less.
13Questions
  • 1
    First and last name of the person filling out this form
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  • 2
    Where we can reach you with follow-up info.
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  • 3
    Optional
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    Must be $100,000 or less to be eligible.
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    A few sentences is perfect.
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  • 9
    City, state, and whether it’s in-person or virtual.
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  • 10
    It’s okay to estimate.
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  • 11
    If not, just give us a general idea.
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  • 12
    Check all that apply
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