Skip survey header

MC4JR Partnership Snapshot, F-03050 (06/2022)

The Partnership Snapshot is a tool for your project/organization to share updates related to the MC4JR grant throughout the grant period. These updates can be shared with your Community Liaison (Lilli Minor or Kristen Ramirez) during Office Hours or brief meetings if you prefer. Overall, your Community Liaison hopes to connect with you a few times to discuss this information throughout the grant period. If you do not have information to share at this moment, please feel free to fill out this survey at another time.
We would like to know the timeframe for the information you are providing in the next two questions.
This question requires a valid date format of MM/DD/YYYY.
This question requires a valid date format of MM/DD/YYYY.
4. If your project/organization has developed any new or deepened community partnerships around your project focus during the timeframe you have specified, please list those on the table below.

Note: we are defining a "new" partner as one with which you did not have a previously established relationship. We are defining a "deepened" partner as one with whom you are continuing to work in a strengthened or expanded capacity.
Space Cell Number of New PartnershipsNumber of Deepened Partnerships
Academic Institutions
Asian American and Pacific Islander-Serving Institution
Community-based and civic organizations
Correctional facilities and institutions organizations
Faith Based Organizations
Healthcare providers
Health-related organizations
Local governmental agencies and community leaders
Nongovernmental organizations
Rural health clinics and critical access hospitals governmental organizations focused on non-health services
Schools/school districts
Social services providers and organizations, including those addressing social determinants of health
State offices of rural health or equivalent, state rural health associations
Tribes, tribal organizations
State Health department
Local health department
Council, community group, coalition or other working group
Mental or behavioral health
Federal agency (other than CDC)
Corporation, industry or private sector
Individual community members