Art in Health Spaces Application
Applicant Information
Full Name
Email Address
Phone Number
Affiliation (if any)
Artwork Proposal
Title of Artwork
Type of Artwork (e.g., painting, sculpture, installation, etc.)
Description (concept, materials, intended impact)
Dimensions / Space Requirements
Proposed Duration of Display
Target Audience & Location
Intended Audience (patients, staff, visitors, etc.)
Preferred Location within Health Space
Previous Experience
Relevant Experience (if any)
Portfolio Link (if any)
Additional Information
Additional Notes / Special Requirements