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Grant Request Form

Here are a few things to consider when submitting your Grant request:

A grant is a voluntary award of funds by LEO Pharma to a worthy and eligible recipient.  The recipient must have submitted an unsolicited request to support bona fide independent educational programs, activities, or materials which benefit HCPs, patients or other public health initiatives.  This also includes research grants for non-Investigator Initiated Studies with a focus on LEO Pharma's therapeutic areas or disease states of interest, including Dermatology and Thrombosis. 

Worthy and eligible recipients of a Grant include institutions, professional or scientific organizations, hospitals, academic medical centers, schools of nursing or pharmacy, professional societies and associations, and other entities with a mission related to healthcare professional education and/or healthcare improvement or patient advocacy associations.

Please note that we cannot award grants directly to individual healthcare practitioners.

All fields marked with an asterisk must be completed in order to process your request. We aim to notify applicants within 90 days of receipt.

Please note Grant funding can be awarded to groups or organizations only, not individuals.

Applicant Organization Details

Grants cannot be made payable to individual Healthcare Practitioners.
 All funds are paid by EFT. If your request is approved, we will contact you for EFT information.
Government employee means involvement in formulary or reimbursement decisions, participation in guidelines committees or practice protocol development or Hospital P&T committees.

Project/Program Information

Funding Details

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