NYSFAMC Subcommittee Membership Questionnaire for New SC Members

Subcommittee Membership Questionnaire

For New Subcommittee Members
Introduction

Thank you for your interest in being a subcommittee member with the NYS Food as Medicine Coalition! Joining a subcommittee(s) will provide you with the opportunity to participate more directly in the work of the coalition. Each subcommittee focuses on a different sector within the food as medicine landscape, but together, they collectively work towards a future where food as medicine is integrated into the healthcare system of New York State.

We value your time and expertise and want to ensure that our subcommittees are the best fit for you. This questionnaire will help us understand your background, interests, and allow us to suggest areas in which your expertise would be valuable to the coalition. The questionnaire should take no more than 10 minutes to complete.
Expectations

Subcommittee members should plan to commit 2-3 hours per month on each subcommittee they participate in. This includes:
- Attending quarterly all-coalition meetings
- Attending quarterly subcommittee meetings
- Contributing their time, talents, and expertise to the subcommittee’s work in between meetings
- Staying informed on coalition news, events, and resources.
Basic Information
Name*

First NameLast NamePronouns (optional)
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Extension
Your Organization:*
Your Current Role/Position:*
Please select the descriptor that best matches your organization:

Non-ProfitFor-ProfitAcademiaHealthcareGovernmentManaged Care OrganizationOther
Background and Experience
Please provide a brief bio detailing your background and experience (200 words max):*

0/200
Do you consent for your bio and contact information to be shared with other coalition members for networking purposes?*

YesNo
Do you work at an organization that provides Food as Medicine services?*

YesNoDon't Know
If yes, what types of FAM services does your organization offer?

Medically Tailored MealsMedically Tailored GroceriesProduce PrescriptionFood FarmacyPantry Stocking (Healthy Pantry)Other
Subcommittee Interests
There are 6 subcommittees in the New York State Food as Medicine Coalition:

Education of the Medical Community
Educates and engages current and future healthcare practitioners on food as medicine services and programs.

Food as Medicine Implementation
Develops best practices for effective food as medicine program implementation.

Membership
Establishes coalition mission, vision, governance, and manages direction of membership.

Mentorship, Education, and Outreach
Promotes the education of the general public and community-based organizations on food as medicine and supports new program development.

Policy and Legislation
Monitors and promotes food as medicine legislative initiatives across New York State.

Research and Evaluation
Maintains a compendium of current FAM research and advises on program evaluation methods.
Which subcommittees are you interested in joining? (Select all that apply)*

Education of the Medical CommunityFood as Medicine ImplementationMembershipMentorship, Education, and OutreachPolicy and LegislationResearch and Evaluation
Thank you for your time and interest!

We will review your submission and get back to you soon. Please direct any questions to: vic@thefoodpantries.org.
Should be Empty:

Subcommittee Membership Questionnaire

Basic Information

Background and Experience

Subcommittee Interests

Thank you for your time and interest!