Healthcare Connect Fund Eligibility Survey

The Virginia Rural Health Association is currently determining eligibility for the FCC/USAC Healthcare Connect Fund and is requesting the following information.  Contact if you have any questions. 
Please provide your contact information
Please provide contact information for someone physically located at each site. If you have multiple sites, please fill out a separate application with the unique contact information for someone that is physically located at each individual site. 
Describe the facility located at this address. *
Is this facility: *