Grant Application | Colter's Watch

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Applications Are Not Yet Open

We are working hard to build our grant program and finalize our partner network so we can serve mothers the right way. We want to be fully ready before we open applications — because you deserve that.

You can still preview and fill out this form, but submissions will not be reviewed until we officially launch. Visit our Apply page to be notified the moment we open.

Notify Me When We Open →

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Colter's Watch provides grants of $400–$600 to cover the cost of a Level 2 anatomy ultrasound (with color Doppler) for mothers who may not otherwise have access. Grants are paid directly to your provider — you never handle funds yourself. This application takes about 5 minutes.

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Contact Information

How we'll reach you about your application

First Name *

Please enter your first name.

Last Name *

Please enter your last name.

Phone Number *

Please enter a phone number.

Email Address *

Please enter a valid email address.

City *

Please enter your city.

State *

Please select your state.

ZIP Code *

Please enter your ZIP code.

County

Helps us find local partners near you

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Pregnancy Information

Help us understand where you are in your pregnancy

Weeks Pregnant *

At the time of this application

Please enter your gestational age.

Estimated Due Date *

Please enter your due date.

OB / Midwife / Provider Name *

Please enter your provider's name.

Practice or Clinic Name *

Please enter your clinic name.

Provider Phone (optional)

Preferred Scan Location *

Hospital, clinic, or radiology department where you'd like the scan performed

Please enter your preferred scan location.

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Insurance & Financial Need

We prioritize mothers who face financial barriers to care

Current Insurance Status *

Uninsured I have no health insurance coverage

Underinsured I have insurance but it won't cover this scan (high deductible, denial, etc.)

Medicaid — Pending or Limited Medicaid approval is pending, or specialty scans aren't covered in my area

Private Insurance — Denied My insurance denied coverage for this scan

Please select your insurance status.

Household Size *

Please select your household size.

Annual Household Income *

Approximate range is fine

Please select an income range.

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Your Story

Help us understand your situation — there are no wrong answers

Do you have any high-risk pregnancy factors? *

Yes No Unsure

Please select an option.

Why is this scan important to you? *

2–4 sentences is plenty. Tell us about your situation in your own words.

Please share a brief statement.

How did you hear about Colter's Watch?

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Review & Sign

Almost done — please review and confirm below

I certify that all information in this application is true and accurate. *

I understand and agree to the terms described above. *

I give Colter's Watch permission to contact me about my application. *

Full Legal Name (as signature) *

Please enter your full name as a signature.

Today's Date *

Please enter today's date.

Application Received

Thank you for trusting Colter's Watch with your story. Your application has been received and will be reviewed personally by our team.

We will be in touch within 5–7 business days by phone or email.

Every scan we fund is dedicated to a little boy named
Colter James Holzapfel ❤️

Colter's Watch