Donation Request

Thank you for your interest in Go Physical Therapy. Since 1987, we have been strongly committed to giving back to the communities we serve. As part of that commitment, we try to stay involved in the events and causes that are important to our company and our employees, and attempt to help as many organizations as we can.

Online Application

Requests for donation, sponsorship or advertising will only be considered via this electronic form. We will thoughtfully consider every request that meets our requirements.

  • Requests for fundraisers and events must be submitted no less than 2 months and no more than 6 months prior to event date or deadline.
  • For a non-date specific request such as an advertising request, please select “Other.”
  • All requests must demonstrate a form of recognition of our company for the donation.
  • A receipt must be provided.
  • The form below must be filled out in its entirety. Valid information is required in case we need to contact you.
  • Go Physical Therapy does not fund: individuals, endowments, religious groups for religious purposes, or political organizations. Go Physical Therapy also does not accept requests for sponsorship via third parties contacting on behalf of a school, team, or other organization. Requests must come directly from the funded entity.

"*" indicates required fields

This field is for validation purposes and should be left unchanged.
Name*
Address*

Event/Organization Information

Details of the request are required. To consider an event or proposal, requests must be made between two to six months before the event or proposal date or deadline. Please select “Other” if your request is not date-specific.
Type of request*

MM slash DD slash YYYY

Other Details

Is your organization a Tax Exempt 501 (C)3?
Will you provide photographs or videos to Go Physical Therapy that demonstrate our support of the event?