The Community Benefit information reported through this Web site is used for several reports that the Health System prepares for reporting our contributions to the community. Some of these reports ask for very detailed information about our community benefit event, and we are trying to improve our data collection efforts so that we can accurately report our contributions. We encourage you to use this form to provide us with detailed information about your activities.
To fill out the Community Benefit Reporting form:
- Click here to open the Community Benefit reporting form.
- Save the form to your computer using “Save As”.
- Rename the file with an identifier for your event (Example: Meals on Wheels = MOW.docx)
- Enter your data and then save it.
- Email the completed Community Benefit reporting form to the Community Benefit Committee at firstname.lastname@example.org.
- You can send separate emails as you complete your reports or attach multiple reports to a single email.
- It is possible, and you are encouraged to submit several forms for the same community event if the program consists of various different types of activities. For example, a department, program or individual should submit:
- one form to report each health screening event,
- one to report each health festival/fair,
- one to report each community educational session, and (unless it is part of a series)
- one to report in-kind staff support for community coalitions.
Submitting several forms will provide us with more detailed information about each type of activity. If you are submitting various forms, please avoid double-counting activities, expenses or revenues by allocating these data as appropriately as possible.
Please refer to our Community Benefit Glossary for help with the terms used in our form. Any other questions related to reporting Community Benefits can be directed to the Community Benefit Committee through our email address email@example.com.