Partnership Survey
Your responses to the following questions will help us to develop a suitable partnership. You will be contacted by a VisionSpring representative within 48 hours of submitting this form.
1. Organization Name
Your answer
2. Organization Website
Your answer
3. Contact Information
Contact name, email & number
Your answer
4. Mission/ Strategic Focus
What is the mission of your organization?
Your answer
5. What State(s) do you operate in?
In which region do you operate?
6. Target Population
Who does your organization serve?
7. Delivery Financing
Do you sell your service or product, or provide it at no cost?
8. Operational Models (select any that apply)
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