Resource Video Participation

Description

The Caswell Chapter of The Health Collaborative is working with its partners to create a series of videos to help members of the community learn about more about area resources. We hope this project will help agencies and organizations share their work while helping residents find the resources and supports needed to thrive here in Caswell.

Question Title

* 1. Would you be interested in participating in The Health Collaboratives' resource video?

Yes

Question Title

* 2. Which category do you feel your organization would best fits into?

Access to Healthcare - Increase access to healthcare, resources and education for low income, minority and other under-served populations

Healthy Eating - Provide equitable access to local, fresh and healthy food

Active Living - Create equitable access to opportunities to be physically active

Healthy Spaces - Local institutions and community organizations encourage healthy living and create policies, programs and environments that support health

Leadership and Capacity - Maintain and build a strong and active collaborative structure with broad ownership and leadership opportunities, representing the diversity of the Dan River Region

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* 3. Do you have a representative to speak on behalf of your organization in the video?

Yes

N/A

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* 4. Does your organization have a website or social media to help us disseminate the resource video once it’s done?

Yes

N/A

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* 5. If you're interesting in participating in the resource video please list your contact information below.

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 6. If you are unable to participate in the resource video, please explain why.

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* 7. Do you have suggestions of other community resources that would be willing to participate in this video?

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* 8. If you have any questions please contact Shannon Moretz at smoretz@caswellmedical.org or 336.694.1181, ext. 221. If you have any additional comments you'd wish to add please list them below.

Thank you for your participation.

Resource Video Participation

Description

Question Title

* 1. Would you be interested in participating in The Health Collaboratives' resource video?

Question Title

* 2. Which category do you feel your organization would best fits into?

Question Title

* 3. Do you have a representative to speak on behalf of your organization in the video?

Question Title

* 4. Does your organization have a website or social media to help us disseminate the resource video once it’s done?

Question Title

* 5. If you're interesting in participating in the resource video please list your contact information below.

Question Title

* 6. If you are unable to participate in the resource video, please explain why.

Question Title

* 7. Do you have suggestions of other community resources that would be willing to participate in this video?

Question Title

* 8. If you have any questions please contact Shannon Moretz at smoretz@caswellmedical.org or 336.694.1181, ext. 221. If you have any additional comments you'd wish to add please list them below. Thank you for your participation.

* 8. If you have any questions please contact Shannon Moretz at smoretz@caswellmedical.org or 336.694.1181, ext. 221. If you have any additional comments you'd wish to add please list them below.

Thank you for your participation.