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APPLICATION FOR: PROGRAM or EVENT SPONSORSHIP

APPLICATION FOR: PROGRAM or EVENT SPONSORSHIP2020-07-13T00:06:48-07:00

TRI-CITY MEDICAL CENTER’S PILLARS OF EXCELLENCE:

  • CARDIOVASCULAR
  • ORTHOPEDIC
  • EMERGENCY SERVICES
  • PRIMARY CARE

Tri-City Medical Center has refocused its community engagement activities to support projects that make a meaningful contribution to community health in our primary service areas (Carlsbad, Oceanside, and Vista), with particular focus on priority services provided by TCMC and the top health needs outlined by the Hospital Association of San Diego and Imperial Counties (HASDIC) Community Health Needs Assessment (CHNA) . If your organization would like to request sponsorship please complete the below form, including which health needs your program or event will address and describe the outcome metrics or impact this investment will have in our community.

Please select which sponsorship you are applying for. If you have multiple sponsorship requests, please provide one application per request:

ORGANIZATION INFORMATION

PROGRAM INFORMATION

EVENT INFORMATION

PLEASE CHECK APPLICABLE PRIORITY HEALTH NEEDS & SOCIAL DETERMINANTS OF HEALTH & PROVIDE A DETAILED DESCRIPTION.

Priority Health Needs

Aging ConcernsCancerAlzheimer’s DiseaseChronic ConditionsParkinson’sCardiovascular DiseaseDementiaFalls/ Limited MobilityDiabetesObesityBehavioral Health

Social Determinants of Health

Access to Health Care or ServicesEconomic SecurityHomelessness & Housing InstabilityStigmaCommunity & Social SupportUnintentional Injury & ViolenceEducation

DELIVERABLES and REPORTS

With this program sponsorship, your organization agrees to provide a detailed recap of results achieved within 15 days from the close of the program/event. If the program extends into multiple years, your organization agrees to prepare and provide an Annual Report, in writing, which can be presented by the organization to the Tri-City Healthcare District’s Board of Directors and/or staff if requested. The report should include all information requested in the Program Information section above, plus any other details you would like considered.

AGREEMENT

By submitting this application, I agree to the terms and conditions outlined in this Application for Program Sponsorship

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