Skip Navigation

Reporting Form

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:

  1. Email the completed Community Benefit reporting form to the Community Benefit Committee at

Helpful hints:

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