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Posted: April 14th, 2022

Community Partnership Program: Taskforce Information

Community Partnership Program: Taskforce Information

Instructions: Identify three to five leaders to participate on your community partnerships taskforce. This interdisciplinary team should be diverse, represents multiple departments, and should be in a director-level or higher leadership role within the organization. You will be presenting this to your executive leadership team. (Please adjust spacing, as needed, for your information.)

Location of Healthcare Facility (Include City and State):

Taskforce Leader #1 Information

Taskforce Leader #1(Title or Role):

Reasoning for Taskforce Leader #1:

Special Population Example with a Description of Contribution for Taskforce Leader #1:

Taskforce Leader #1: Proposed Partnership Information

Community Partner’s (Organization) Name:

Community Partner’s Website:

Summary of the Community Partner’s Services and/or Products with a Reasoning for Partnership:

Taskforce Leader #2 Information

Taskforce Leader #2(Title or Role):

Reasoning for Taskforce Leader #2:

Special Population Example with a Description of Contribution for Taskforce Leader #1:

Taskforce Leader #2: Proposed Partnership Information

Community Partner’s (Organization) Name:

Community Partner’s Website:

Summary of the Community Partner’s Services and/or Products with a Reasoning for Partnership:

Taskforce Leader #3 Information

Taskforce Leader #3(Title or Role):

Reasoning for Taskforce Leader #3:

Special Population Example with a Description of Contribution for Taskforce Leader #1:

Taskforce Leader #3: Proposed Partnership Information

Community Partner’s (Organization) Name:

Community Partner’s Website:

Summary of the Community Partner’s Services and/or Products with a Reasoning for Partnership:

Taskforce Leader #4 Information

Taskforce Leader #3(Title or Role):

Reasoning for Taskforce Leader #3:

Special Population Example with a Description of Contribution for Taskforce Leader #1:

Taskforce Leader #4: Proposed Partnership Information

Community Partner’s (Organization) Name:

Community Partner’s Website:

Summary of the Community Partner’s Services and/or Products with a Reasoning for Partnership:

Taskforce Leader #5 Information

Taskforce Leader #3(Title or Role):

Reasoning for Taskforce Leader #3:

Special Population Example with a Description of Contribution for Taskforce Leader #1:

Taskforce Leader #5: Proposed Partnership Information

Community Partner’s (Organization) Name:

Community Partner’s Website:

Summary of the Community Partner’s Services and/or Products with a Reasoning for Partnershi
p:

————

Taskforce Information for the Community Partnership Program

Instructions: Form a taskforce of three to five leaders to work on community partnerships. This interdisciplinary team should be diverse, represent multiple departments, and be led by a director or higher in the organization. You will make this presentation to your executive leadership team. (If necessary, please adjust the spacing for your information.)

Healthcare Facility Location (Include City and State):

Information from Taskforce Leader #1

Taskforce Leader Number One (Title or Role):

Reason No. 1 for Taskforce Leader:

Special Population Example with a Description of Contribution for Taskforce Leader #1:

Taskforce Leader #1: Proposed Partnership Information

Community Partner’s (Organization) Name:

Community Partner’s Website:

Summary of the Community Partner’s Services and/or Products with a Reasoning for Partnership:

Taskforce Leader #2 Information

Taskforce Leader #2(Title

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