Create - LSUHSC Community Outreach

Community Outreach Form

Project/Event Name

Project Coordinator

Phone Number

Email Address

Will LSUHSC School of Public Health resources be used?

Event Date

Time

List organizations/partners collaborating on this event.

Is this a recurring event?

Breif description of the project and services to be provided.

Specify Recurring dates, days, time and expected end date.

Number of LSUHSC students or residents who will participate

Number of community members/patients served

Will photos be taken?

Department

OutreachCategory

ServiceProvided

Is this service part of a result grant funding?