Community Partnership Application
Type: Partnership, sponsorship, or funding
Location: The partner and event must be in the Optima Health service area.
Reach: Must reach or impact at least 100 people.
Theme: Must align with the Optima Health vision and core values of:
- Promoting health and wellness
- Addressing care gaps and social determinants of health
Provide: All partnership activities must provide Optima Health with the following:
- A means through which to convey key messages about our services, mission, etc., including but not limited to signage, advertising, or media exposure
- Ability to promote our participation in accordance with the event’s marketing objectives
- An opportunity to provide input and approval of all references to Optima Health such as logo, signage, and press releases
Required: At least one of the following is required:
- Benefits a group or organization that promotes medical, physical, mental and emotional health, safety, and wellness
- Promotes community unity and cultural enrichment and/or diversity
- Has an educational impact on children and/or adults
- Assists in the aftermath of a local crisis
- Demonstrates collaboration and coordination with other community organizations
- Event/activity is relevant to the needs of the community
- Social determinants of health
- Maternal and child health
- Screenings and preventive health
- Chronic condition and disease management
Not Accepted: Optima Health will not accept requests that benefit:
- Tournaments of any kind
- Organizations already supported by our Employee Giving Campaigns (i.e. United Way, American Heart Association)
- Political and labor organizations
- Sports teams, little leagues, or booster clubs
- Alcohol, tobacco, or gambling-themed events
Please apply at least three months prior to the event. There are regulatory approvals included in our process that may impact the decision timing.
Please complete the application form and email it to firstname.lastname@example.org.
- Only one request per form. However, organizations may submit more than one request at a time.
- Do not send any other information with your form.
- We will not consider incomplete or illegible requests.
- Selected organizations must supply a W-9 and a supplier verification form.
Applications are due by the first of each month. The Optima Health Community Partnership Program committee reviews them on the 15th of every month.
We prioritize requests that fit our mission and values, and improve the health and quality of life of the community.
We regret that we cannot approve every request. Funds are limited. We may accept some requests at a lower level.
If approved, we will email the contact listed on the Community Partnership application form.
No funds will be dispersed prior to the receipt of all proper documents:
- Supplier verification form
- Invoice including the event name, the award amount, the organization’s EIN, the payee, and mailing address
Please email payment request information to email@example.com. The Optima Health Accounts Payable department will process payment within 7-14 business days via check or EFT.
For questions about our Community Partnership Program, please call your local Market Development & Outreach Specialist or email firstname.lastname@example.org.