1400 Eastside Road, Platteville, WI 53818
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608.348.2331
Search
Find A Doctor
Search Providers
Southwest Health Clinics
View All Providers
About
Awards & Recognitions
Board of Directors
Community Health Needs
Connecting for Healthier Communities
History
Leadership Team
Nondiscrimination Statement
Patient Financial Services
Quality and Pricing
Vision and Values
Visiting Southwest Health
Our Services
Audiology
Birth Center
Cancer Care
COVID19 UPDATES & INFO
Dermatology
Diabetes Education
The EDGE
Emergency & Urgent Care
Emergency Medical Services (EMS)
Eye Center
Financial Assistance
General Surgery
Health Information
Laboratory
Mammography
Massage Therapy
Medical Imaging
Mental Health
Nutrition Services
Orthopedic Institute
Otolaryngology / ENT
Pain Management
Patient Financial Services
Pediatrics
Pharmacy
Pregnancy
Primary Care
Rehabilitation & Therapy
Senior Care
Sexual Assault Support
Sleep Lab
Specialty Clinics
Speech Therapy
Swing Bed Program
Women’s Center
My Healthy Life
Activity
Cancer Support Group
Class Schedules
COVID19 UPDATES & INFO
The COVID Vaccine
Depression Screen for Adults
Food & Eating
Know Your Numbers
Life Apart. Healthy Together.
Minds
Preventive
Programs & Events
Say It Out Loud! Art Contest
Sole Mates Walking Club
Work
Young at Heart
Media
Advertising
Community Engagement
Gallery of Gratitude
Heart 2 Heart Magazine
News
Social Media
Sponsorships & Donations
Videos
Giving
About the Foundation
Donate Online
Employees That Care (ETC)
Golf Outing
Moments of Impact
Scholarships
Volunteer
Ways to Give
Careers
Apply Online
Career Opportunities
Physicians
Student Experiences
Survey
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Blog
Baby Gallery
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Sponsorship / Donation Request Form
Sponsorship / Donation Request Form
Organization Details
Company/Organization Name
Name
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Is your organization tax exempt?
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Our vision is creating a healthier southwest Wisconsin, and our top criteria for supporting programs is whether it provides a DIRECT health benefit. Describe how your organization or this program addresses community health needs in southwest Wisconsin.
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Event / Project Details
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Date of Event/Project
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Please include the address details of the event/project below.
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Description of Event/Project
Describe in detail the nature of your event or sponsorship/donation request
Projected attendance at event/project?
How many years has this taken place?
Attendance last time?
What percent of the funds raised will directly benefit people in southwest Wisconsin? Also what percent is used for administrative expenses?
Response Deadline
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Cost of Sponsorship
If available, what are sponsorship levels and associated benefits?
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Are there any other reasons this organization/program/event should receive funding?
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Please review our sponsorship/donation policy above before submitting this form. After you click "Submit" you will receive an automatic email to the address you listed.
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