New York State Food as Medicine (FAM) Program Survey
Program Name:
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Type of FAM Program
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Medically Tailored Groceries
Medically Tailored Meals
Produce Prescriptions
Food Farmacy
Other
Organization:
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Service Area (city/county/target population):
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Contact Name:
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Phone Number
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Please enter a valid phone number.
Email:
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Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Program website or social media platform (URL):
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Funding Source(s):
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Do you have a set rate? If so, what is your service rate? Does it fully fund your FAM program? If not, how much is the gap and what is unfunded?
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Please provide a number and explanation
Do you have barriers to using NY Produced Food? If so, what are the barriers?
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Do you receive Nourish NY through your food bank or do you have a direct contract?
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Do you have a health professional on staff (RDN, nurse, etc.): Please list how many and what kind.
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How do you get your food?
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How do you get your food to your participants?
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What are your Clinical Care Elements/Outcome Measures?
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Other Program Measures/Metrics:
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Educational Resources:
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What would make your program better/more sustainable?
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On June 30th we are holding a statewide partner convening around FAM, who should we send an invite to? Please provide name and email of those who would like to attend:
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Submit
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