Community Events & Engagement Request

Thank you for expressing interest in having Summa attend an upcoming event, provide materials for an event or exploring ways that your organization can partner with Summa in the community.

General Guidelines

Location: is your event taking place at a location within a community we serve in one of the following counties: Medina, Portage, Stark, Summit or Wayne?
Advanced Notice: is the event you are requesting support for a minimum of 6 – 8 weeks away from today’s date?
Summa Health prioritizes collaborations with community groups, clubs and organizations that support and address the social drivers of health, as identified in our Community Health Needs Assessment (CHNA) and Community Health Improvement Plan (CHIP).

Please complete the form below. Questions marked with an asterisk (*) are required.

Name of Organization

Contact Name

Contact Phone

Contact Email

Organization Website/Social Media Link

Is this a partnership request?

Yes

No

Describe this possible partnership opportunity between your organization and Summa Health in as much detail as possible.

Name of Event (If this is a request to partner with Summa, please write N/A)

Type of Event (health fair, etc). If this is a request to partner with Summa, please write N/A.

Describe the Core Audience for this Event.

Date of Event

Address of Event

Requested Specific Items or Quantities Needed for Event

If materials are needed in advance, please provide requested delivery date

Delivery Address for advance materials (contact name, street address/office number, email/phone number)

Number of Expected Event Attendees (choose one)

15-25

26-35

36-50

51-75

76-99

100 or more

Additional Comments or helpful information

I have read the general guidelines section of this request form.

Community Events & Engagement Request

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