Application forms
These forms are updated as needed and new versions will be uploaded as they become available. Please check to make sure that you have the most recent version.
Please read the following descriptions carefully and choose the application that most closely fits your request. If you cannot find a form that fits your request, contact the appropriate regional grants administrator. Applications can be completed online and submitted electronically to the appropriate regional grants administrator.
Important: Give us as much time as possible to consider your request. It takes a full 60 days after a complete application is received to determine whether or not the request will be granted. Additional time is needed to process the request through legal, finance, and to order products, if necessary.
Form download instructions
To download forms, please follow these instructions. Make sure that you are opening the form in Adobe Acrobat and not in a browser (e.g., Google Chrome, Internet Explorer, Safari).
- Right-click the link to the form you would like to download.
- Choose “save as” and select a location on your computer where you want to save the form.
- Open the form from your saved file in Adobe Acrobat or Adobe Reader, complete the information, and save the file again. You may also contact us at Grants@CookMedical.com for assistance in obtaining these forms.
- When submitting your application via email, do not attach files that total more than 10 mb. If your files add up to more than 10 mb, please contact your regional grants administrator for alternate instructions for your files.
Grants for charitable programs
These donations are for programs that serve charitable purposes, such as medical care for underserved patients, or patient or public education. Donations must be for bona fide charitable purposes and can be made only to charitable organizations and other non-profit entities with bona fide charitable and/or philanthropic purposes. These donations are also available for events where proceeds are intended for charitable purposes.
Product donations for charitable programs
These donations are for programs that serve charitable purposes, such as medical care for underserved patients, or patient or public education. Donations must be for bona fide charitable purposes and can be made only to charitable organizations and other non-profit entities with bona fide charitable and/or philanthropic purposes. These donations are also available for events where proceeds are intended for charitable purposes.
Requests for product that will be used at third-party educational conferences or programs for healthcare professionals should be made on the Cook Product Donations for Third-Party Educational Use application.
Third-party educational conferences
These grants are for use by educational institutions, professional societies, or other third parties to request financial support for educational conferences, seminars, or professional society meetings that they are organizing.
Cook Medical is not permitted to support educational conferences or programs that are organized by healthcare institutions that restrict attendance to their own healthcare professionals who are not in training. (Grants cannot be used for exhibit fees or other fee-for-service arrangements.)
- The meeting must be bona fide educational, scientific, or policymaking.
- The meeting must promote scientific knowledge, medical advancement, and the delivery of effective healthcare.
- The meeting must be independent of Cook Medical, meaning Cook Medical cannot select speakers or control content, methods, or materials.
- The meeting must follow the criteria established by the Accreditation Council for Continuing Medical Education (ACCME) to avoid losing continuing medical education accreditation.
Requests for third-party conferences or educational institutions for grants to provide scholarships to HCPs-in-training should be made on the Conferences Grants for HCP-in-Training application.
Product donations for third-party educational use
These grants are for products that will be used at third-party educational conferences or programs for healthcare professionals. Cook Medical cannot control the program content. (These product donations cannot be used for Cook Medical-organized product training or for institutions that are training their own staff only.)
Cook Medical does not consider requests for products that are:
- Not commercially available
- Stock items on backorder
- Non-stock items
- Custom-made items
- Items that will be used or demonstrated for use in an off-label indication
- Not approved and licensed for sale in the country where the product will be used
- Products that require a pharmaceutical license
Conference grants for HCPs-in-training
These grants are for an educational institution or professional society that wishes to support the educational advancement of healthcare-professionals-in-training (HCPs-in-training), defined as medical students, interns, residents, fellows, and nursing students. The requesting institution or society is responsible for selecting the beneficiaries of the grant. Some governments and institutions have their own requirements for making these selections.
Keep the following things about educational grants in mind:
- Educational grants are provided to training institutions or conference sponsors to support healthcare professionals who are in training and who have been selected by the training institution or conference.
- Educational grants will be given only for the support of legitimate expenses for bona fide educational activities.
- Grants must be consistent with conference standards
Note: Cook Medical cannot review applications that are submitted by individual HCPs-in-training or provide grants for education directly to HCPs-in-training. Institutions must apply for educational grants.
Grants for fellowship or residency programs
These grants are for accredited fellowship or residency programs offered by healthcare institutions for HCPs-in-training (defined as medical students, interns, residents, fellows, and nursing students). The requesting institution or society is responsible for selecting the beneficiaries of the grant. Some governments and institutions have their own requirements for making these selections.