Organization Interest Form
Thank for your interest in improving community health and participating in MAPP’s Community Health Needs Assessment. The more voices we are able to engage in this process, the better! The final report is scheduled to be publishes spring 2023. Please email mappofskp@gmail.com with any questions or for more information.
Name of organization
Name of contact person
Email of contact person
Phone number of contact person
Please enter a valid phone number.
Physical address of organization
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Preferred date
Preferred time
What assessment option do you think works best for your organization?
Intercept Survey (a brief survey done verbally and in person, often while folks are waiting in line somewhere)
Perceptions of Health (a longer survey administered electronically or on paper)
Focus Group Discussion (60-90 minute dialogue with an established group)
Stakeholder Interview (a one-on-one interview with someone who can speak on behalf of a group)
Unknown (please contact me to determine which tool is the best fit!)
Any questions or additional information?
Submit
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