Community Benefit

Name
First Last
Email
Sponsoring Department
Name of Program/Event*
Location of Program/Event:
Program Date
Date Format: MM slash DD slash YYYY
Program Description
Who, What, When, Where, Why? - What was done? Who was served?
What is the impact on health?
What was the Community Health Need being addressed and how was the need demonstrated?
How many people attended?
What is the target population?
Lead Person(s)*
Include all persons who were leaders or contact persons in SH's participation in this program as well as how much time they dedicated toward the entire project.
Name Hours Description of Job
Additional Staff
Include any additional SH staff that participated in this program as well as how much time they dedicated toward the entire project.
Name Hours Description of Job
Program Costs
Include all employee labor cost (time dedicated x current hourly wage), supplies, travel & other expenses. Click on the Plus sign at the end of the row to add more.
Description Cost

COVID-19 AND VACCINE UPDATES

Name	Hours	Description of Job

Name	Hours	Description of Job

Description	Cost