ZSFG CWP Garden Giveaways Agreement
Purpose: The mission of the Garden Giveaways Program is to inspire the incorporation of fresh, seasonal vegetables into the diets of ZSFG patients. Hospital grown produce is distributed to deserving patient education groups on grounds. The Community Wellness Program aims to promote healthier dietary choices by also distributing health education materials with this produce to engage patients to adopt healthier eating practices.

The Community Wellness Program will coordinate the harvesting and distribution of produce. It will provide recipe books (in English, Spanish, or Chinese) for the first group meeting. It will work with Group Facilitators to obtain weekly patient numbers. It will construct and provide a patient survey to be filled out at the end of the program. The patient surveys are very important to assess the impact of the Garden Giveaways Program on each individual participant and each group, and will be compiled for grant as well as future research opportunities.

Group Eligibility: A group will be considered eligible if it meets consecutively for a series of time, meets four or more times, has participants that return each week, and the GROUP FACILITATORS UNDERTAKE THE FOLLOWING RESPONSIBILITIES:

1. Filling out the initial Garden Giveaways Agreement (this form).
2. Retrieving produce bundles from the Community Wellness Center refrigerator each week and distributing them to group participants.
3. Distributing the Garden Giveaways cookbook and answering questions about its recipes with participants.
4. Distributing and facilitating the completion of patient surveys on the last day of class, and ensuring those surveys are returned to CWP (InterOffice Mail: ATTN: Khadijah Grant Rm: 2D 35 Wellness).

Applications Due May 10, 2019
Garden Giveaways Start Date: May 20, 2019


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Does your group meet the criteria to participate in the Garden Giveaways Program? *
(Select all that apply)
Required
Do you agree to fulfill the responsibilities requested of you as a Group Facilitator with the CWP Garden Giveaways Program? *
Required
Your Name: *
Group Name: *
Group Meeting Place: *
Email: *
Phone Number: *
List all dates and times your group will meet?
Ex: February-May 2019, 2nd Monday at 6:30 pm                          (Should you have multiple groups in 2016, please list those sessions as well)
How many bundles of produce do you anticipate requesting each week? *
Please estimate how many patients you anticipate. You can revise this number throughout the season.
How many English recipe books would you like? *
How many Spanish recipe books would you like? *
How many Chinese recipe books would you like? *
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