Charitable Donation Grant Application

Charitable Donations provide support to non-profits and charitable organizations for indigent care, medical missions, humanitarian aid and related philanthropic programs, such as public awareness of medical and health conditions programs.

Who Should Use This Application

This Charitable Donations Grant Application is intended for use by non-profits and charitable organizations for financial support towards bona fide charitable and/or philanthropic indigent care programs, medical missions, humanitarian aid programs, and related philanthropic programs, such as public awareness of medical and health conditions programs.

Acumed does not provide charitable donations to individual health care professionals (HCPs) and does not provide charitable donations that are earmarked for the benefit of individual HCPs.

Acumed will not provide charitable donations:

  • where the circumstances are likely to improperly influence, or appear to improperly influence, medical judgment,
  • where one purpose is to influence an HCP to purchase, lease, recommend, use, arrange for the purchase or lease of, or prescribe Acumed products,
  • when the funds would be used to defray the HCP requestor’s ordinary operating expenses or overhead,
  • when the funds would be used to directly fund payments for exhibit space, consulting or other services or goods provided to Acumed, Acumed promotional activities or events, or any program where any of the speakers are Acumed employees, or
  • when the funds would be in support of or to offset entertainment or recreational activities.

Submission deadline

To be considered, the completed application, including all required supporting documentation, must be received at least 60 days before the need date. If you have any questions, please contact grants@acumed.net

Other Applications:

  • Professional Medical Education Grant Application is intended to be used for all grant requests for independent medical educational programs for health care professionals, including congresses, conferences, symposiums, or courses, with or without labs, that are sponsored by professional medical associations, societies, or continuing education providers and academic institution surgical skills labs.
  • Product Donation Grant Application is intended to be used by non-profit or charitable organizations for in-kind support for indigent care and medical missions.
  • Collaborative Research Opportunities is intended to be used for all requests for support towards research proposals and research studies

Acumed | OsteoMed Grants Committee

In October 2020, Colson Medical, LLC - part of Marmon Holdings, Inc., a Berkshire Hathaway company - announced the merger of Acumed and OsteoMed. The Acumed | OsteoMed organization are pleased to announce a combined Grants Committee.

Contact Information

All notifications, questions, etc. regarding this grant application will be directed toward the primary contact listed below.

Primary Contact

Secondary Contact

Applicant Organization Information

Charitable Donation

Program Details

Required Attachments

The following formats are allowed: rtf, odf, pdf, doc, docx. Maximum file size per file is 8 mb.
Click or drag a file to this area to upload.
Click or drag a file to this area to upload.
The letter of request must be on the Applicant Organization’s letterhead and is to include: (i) a description of the Applicant Organization’s overall charitable and/or philanthropic purpose, (ii) identify the indigent care program, medical mission, humanitarian aid program, or related philanthropic program that support is being requested for (iii) the grant amount requested, and (iv) be signed by an individual with the requisite authority to submit the grant application on behalf of the Application Organization.
Click or drag a file to this area to upload.
A detailed description of the specific indigent care program, medical mission, humanitarian aid program, or related philanthropic program that support is being requested.
Click or drag a file to this area to upload.
Itemized budgetary breakdown of how the funds will be utilized within the overall program. For grant requests related to travel or lodging expenses for humanitarian aid medical missions supporting documentation for such expenses are required.

Optional Attachments

Please upload any additional documents, or information that you would like our Grants Committee to take into consideration.
Click or drag a file to this area to upload.
Click or drag a file to this area to upload.

Certifications

This Certification is intended to require the Applicant Organization, Acumed, and their personnel to comply with the laws and regulations applicable to relationships between donors and requestors of grant funding, including but not limited to the federal Anti-Kickback Statute (42 U.S.C. §1320a-7b(b)), state anti-kickback laws and regulations, and the Foreign Corrupt Practices Act of 1977 (15 U.S.C. §78dd-1, et seq.). Acumed reserves the right to modify the requirements of this Certification as Acumed deems appropriate to ensure compliance with state and federal laws and regulations.
(Individual submitting this Grant Application)
I, the Submitter of this Grant Application, certify that to the best of my knowledge all of the following statements are true with respect to the submission of this Grant Application:

  1. I have the requisite authority to submit this Grant Application on behalf of the Applicant Organization.
  2. All information provided in this Grant Application and its attachments is true and accurate as of the date of this Grant Application, and I am unaware of any information or other circumstance that is likely to render any such information false or erroneous. I will promptly notify Acumed in the event that any information provided in this Grant Application and its attachments becomes false or erroneous.
  3. The submission of this Grant Application does not violate the Applicant Organization’s Code of Ethics, Conflict of Interest Policy, or any other policy of the Applicant Organization and does not violate any law or regulation to which the Applicant Organization is subject.
  4. The Applicant Organization, its personnel, and I have not, implicitly or explicitly, solicited the requested grant in exchange for an agreement to purchase, use, order, or recommend Acumed products or as a reward for any prior purchase, use, order, or recommendation of Acumed products. The Applicant Organization, its personnel, and I acknowledge and agree that Acumed’s decision of whether to approve or deny this Grant request is wholly unrelated to any prior or future purchase, use, order, or recommendation of Acumed products. I further acknowledge that any offer to purchase, use, order, or recommend Acumed products in connection with this Grant Application will result in the automatic denial of the Grant request.
  5. The Applicant Organization, its personnel, and I are not a person (or persons) or organization: (a) excluded from a federal health care program as outlined in Sections 1128 and 1156 of the Social Security Act; (b) debarred by the FDA under 21 U.S.C. 335a; (c) otherwise excluded, suspended, or debarred from contracting with the federal government or participating in a federal health care program; or (d) convicted of or under investigation for a health care-related criminal offense, including any violation described in 42 U.S.C. §1320a-7(a).
  6. The submission of this Grant Application does not guarantee approval of this Grant Application, and if approved by Acumed, Acumed may approve funding at an amount less than what has been requested.
  7. If this Grant Application is approved, the Applicant Organization will be required to represent and warrant, in a separate writing, that: (a) the receipt of grant funding will not affect its or its personnel’s’ professional judgment; (b) it will assist Acumed in complying with its reporting duties required by the Physician Payment Sunshine Act and its implementing regulations (42 C.F.R. § 403.900 et seq) as an applicable manufacturer; and (c) Acumed shall have the right to audit the use of grant funds, and the Applicant Organization will provide Acumed with reasonable access to copies of receipts related to the expenditure of grant funding.