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Housing request

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Housing request form for burn & trauma families.

If you have traveled to Hennepin Healthcare in Minneapolis or Region’s Hospital in St Paul with/for an immediate family member who is a patient in a Burn Unit, you can request FREE temporary housing.

We have one-bedroom suites for up to 2 adults (and up to 2 children under 18 years of age).

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Hospital Location(Required)

Adult 1 Information

Adult 2 Information (if applicable)

Demographics

Your responses to these demographic questions helps Firefighters For Healing understand the people we are serving and may allow us to pursue additional areas of funding to best serve the needs of our constituents. All responses are private, are not used for discriminatory purposes, and will not affect your housing intake application.
Are there Americans with Disabilities Act needs?
Race of patient
Is the patient a veteran?
This field is for validation purposes and should be left unchanged.