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Background Information and Beginning of the Form

Did you start a new MLP?
Did your MLP change partners or leadership?

Use this form to provide updated information about your new or existing MLP.

The National Center for Medical-Legal Partnership (NCMLP) tracks information, such as number, type, and location, about medical-legal partnerships (MLPs) nationwide. We use this information to better understand the landscape of MLPs and support MLP advancement efforts. In limited circumstances, this information is used by NCMLP to help the community of MLP practitioners, researchers, and interested stakeholders (e.g., foundations, government agencies, professional associations, or media) connect with each other to exchanges resources and provide support. We do not share, sell, or use your contact information or information about your MLP for commercial purposes.

Please help us continue to strengthen and advance the MLP movement by using this form to keep NCMLP - and the MLP field - informed of current MLP development and implementation efforts.

This form requests only basic information about your MLP. It takes about 5-10 minutes to complete, depending on how much information you have to provide. NCMLP will follow up with you to ensure the accuracy of the information provided and learn more about how we can support you.

Please feel free to email us at ncmlp@gwu.edu if you have any questions.

Thank you.
 
 
 

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* 1. Are you submitting information about a new or existing MLP?

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* 2. What is the name of this MLP program?

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* 3. Where is this MLP located?

Check as many boxes to identify where the MLP is it headquartered as well as where it operates (i.e., provides MLP services to patients/clients).  Use "other" to enter location(s) not listed.

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