My DPC Story - Partner & Sponsor Inquiry Form
We collaborate with organizations aligned with Direct Primary Care, physician entrepreneurship, and patient-first healthcare. This form helps us determine fit and next steps.
Contact & Organization Info
Organization Name
*
Primary Contact Name
*
Role / Title in Organization
*
Decision-maker, marketing lead, partnerships, etc.
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Organization Website
*
Company Size
*
Solo / Small team
2–10
11–50
50+
DPC Experience & Alignment
How familiar is your organization with Direct Primary Care (DPC)?
*
We actively work with DPC clinics
Some experience / learning phase
No experience but interested
Describe your experience working with DPC practices (if any)
*
Which best describes your interest?
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Sponsorship (financial)
Strategic partnership (non-financial or mixed)
Product/service collaboration
Educational collaboration
Other
Sponsorship / Budget Qualification
Are you interested in sponsorship, partnership, or both?
*
Sponsorship only
Partnership only
Both
Estimated Sponsorship Budget
*
$2,000 or less
$2,001–$5,000
$5,001–$10,000
$10,000+
Ongoing / multi-month support
Sponsorship Timeframe
One-time
3 months
6 months
12 months+
Partnership (Non-Financial or Hybrid)
What type of partnership are you proposing?
*
Content collaboration
Podcast sponsorship in-kind
Event collaboration
Product trials or benefits for physicians
Educational resources
Other
What would you like to contribute as a partner?
*
What are you hoping to gain from partnering with My DPC Story?
*
Why do you feel your organization aligns with My DPC Story’s mission?
*
Anything else we should know before reviewing your inquiry?
Submit
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