VSHP Grants Request Form 2022
VSHP’s Mission: The mission of the Virginia Society of Health-System Pharmacists is to inspire innovative pharmacy practice by promoting education, advocacy and collaboration to help people achieve optimal health outcomes.

- All grants will be awarded to VSHP members.
- All grant funds must be used within 12 months of grant's approval date.
- Unused funds must be returned to VSHP.
- Applications will be evaluated based on impact, value feasibility and understanding how the grant fits within the VSHP mission.
- Implementation date, budget update, outcomes reported so far (if applicable) and any pictures (if applicable) must be provided to VSHP every 6 months and a follow-up report to VSHP must be written within one year of disbursement of funds, or when the project has reached a completion milestone, whichever occurs first.
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Requester Name *
Email address *
Affiliation
Describe your proposed program or project, including schedule or timeline as applicable. *
Describe how the project aligns with the VSHP mission statement *
Estimate when funds would be needed *
Describe the total project budget with estimates of costs/expenses and information on any co-funding that is available, or is being sought *
Describe the estimated number of people (eg, patients/providers/other VSHP members) that may be impacted by your project
Describe any outcomes that are being collected.
Do you plan to share results in part or as a whole at a local, regional, or other meeting?
Grant requester will be required to provide a report to VSHP every 6 months d a follow-up report to VSHP must be written within one year of disbursement of funds, or when the project has reached a completion milestone, whichever occurs first with the following information:  Implementation date, budget report out, outcomes reported so far (if applicable) and any pictures (if applicable). Please acknowledge below that grant requester will provide this information to Grants Committee at the time specified.
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