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Community Lab Interest Form
We appreciate your interest in Community Lab! Our Community Lab sessions are open to all who are part of a Community Health Collaborative (CHC) or School Health Advisory Council (SHAC) or interested in starting one.
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Email
*
Your email
Date of Request
*
MM
/
DD
/
YYYY
Name
*
Your answer
Name of Organization/School District/CHC
*
Your answer
Your Title
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Your answer
Address (City, Zip code)
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Your answer
Phone Number
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Your answer
Email Address
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Your answer
How did you hear about Community Lab?
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Your answer
What areas are you interested in learning more about?
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Strategic Planning
Building a Governance Structure
Mission & Vision development
Grants and Funding
Social Marketing
Identifying Community Assets and Barriers
Utilizing a Dashboard Approach for Measuring Data
Building Community buy-in
Health Equity
Social Determinants of Health
Other:
Required
Do you have a dedicate person who can attend monthly sessions?
*
Yes
No
Not sure
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