Minnesota Accountable Health Model: Storytelling Submission Form
Please use this form to develop your health story. We ask that you keep your stories framed around health, community health, and health care experiences.  Through this process, keep the purpose and audience of your story top of mind. This form works in conjunction with the Storytelling Jumpstart Video and the How To Tell An Impactful Story PDF. This is your space to think through and write out the different components of your story before you submit it.

Questions and comments may be directed to:  
Sida.Ly-Xiong@state.mn.us 
Sida Ly-Xiong - State Innovation Model: Community Engagement Coordinator with the Minnesota Department of Health
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Your Name:   *
Your Email Address: *
Your Phone Number: *
Your City/County: *
Health Initiative/Organization (if applicable): *
i.e. "CentraCare Health"
1. Story: Headline *
Give your story a headline/title - i.e. "ACH Improves Health Through Housing Initiative"
2. Describe your program or initiative (<100 words) *
Talk about your mission or vision for your community and how you're working towards those goals.
3. Why do you want to tell your story? *
Why do you think people should hear your story? What partnerships or action do you hope to inspire through telling your story?
4. Boil it down – describe the cause and effect. Connect the dots. *
Give an example of a memorable moment or real situation that highlights the importance of this work.  How were things before, and what changed?
5. Take action! *
What did you learn?  What can or should happen next? Why should potential partners be interested?  What impact can you make together?
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