• CF Application: Virtual Medical Appointments for Hormone or Surgery Assessments

  • Welcome!

    The Connect Fund is a program to help trans and nonbinary people pay for healthcare costs. Before you begin, please think about whether you have other ways to pay for your treatments, like NIHB (Non-Insured Health Benefits) or extended health benefits through work or school. You can email us at info@connectfund.org if you’d like more information about these options. This will help us support others who may not have other ways to pay.

    Important: If you are approved, we will pay the money directly to the service provider—not to you.

    Services:

    Right now, the program is available in Ontario and Alberta.


    After you submit this form, we will let you know within 4 weeks if you are approved. Funds are sent out monthly. If we can’t approve you right away, we’ll tell you when your application will be looked at again.

    If you need funding for something not listed, you can tell us at the end of the form.

    We are here to help—thank you for applying!

    Form details:

    It takes 20-30 minutes to complete.
    We will ask about your needs, personal details, and your current situation.
    Your answers won’t be saved if you close the form before finishing.

  • Are you a trans/nonbinary person seeking help with healthcare costs?*
  • Do you need funds to access care within the next 12 months?*
  • Please select barriers you may have to accessing services*

  • Tell us about your funding needs

  • Please select the service you would like to apply for now. You may apply for another service later (up to a $2,000 funding cap per person per year).
  • Are you currently a patient at Foria?*
  • If no, what service are you seeking?

  • Personal Information

    We collect demographic information (name/ postal code/ email) in order to communicate with healthcare providers and confirm coverage. We collect data about health, social and economic factors in order to understand the fund's health equity process and it does not impact whether you get coverage.
  • Date of Birth*
     - -

  • Applicants must reside in Alberta or Ontario to be eligible for Connect Fund support.

  • Do you currently reside in Alberta or Ontario?*
  • Please describe your living situation*
  • Please describe your current occupational status*
  • Do you have extended health benefits?*
  • Do you identify as a person with a disability (mental or physical)?*
  • Do you identify as Indigenous? Select all that apply*
  • How do you identify your race or racial background? Check all that apply:*

  • Impact of Funding

  • While we strive to support as many community members as possible, we may not be able to meet every funding request at this time.

  • This fund is for trans and non-binary people seeking care in Alberta or Ontario and have no access to financial support over the next 12 months. 

  • Should be Empty: